三维磁共振静脉增强成像对原发性下腔静脉平滑肌肉瘤的诊断价值

Value of 3D CE-MRV in the diagnosis of primary leiomyosarcoma of inferior vena cava

目的：探讨磁共振静脉增强成像（CE-MRV）对原发性下腔静脉平滑肌肉瘤（PIVCLMS）的诊断价值。方法利用1．5T MRI成像仪对6例原发性PIVCLMS患者进行常规扫描及三维动态增强磁共振血管造影（3D CE-MRV）扫描，分析其影像学特征。结果6例患者中，3例起自下腔静脉中段，其中1例并发下段血栓，另3例起自下腔静脉下段，其中1例侵犯右心房。瘤体平均直径4．3 cm（3．0～5．5 cm），3D CE-MRV清楚地显示病灶全貌和肿瘤累及范围。结论 MRI结合3D CE-MRV对PIVCLMS的诊断具有重要的临床应用价值，可以取代传统的血管造影，作为诊断PIVCLMS的首选影像学检查方法。

Objective To explore the value of 3D CE-MRV in the diagnosis of primary leiomyosarcoma in inferior vena cava . Methods Six cases of primary leiomyosarcoma of inferior vena cava underwent MRI and 3D CE-MRV with a 1.5T MRI scanner and the features of the images were analyzed accordingly .Results Of the 6 cases, 3 had leiomyosarcoma from the middle IVC , with 1 case complicated with thrombus in the low section , and another 3 had leiomyosarcoma from the low IVC , with 1 case invading the right atri-um.The average diameter of tumors was 4.3 cm（3-5.5 cm）, and 3D CE-MRV could clearly display the full picture and extent of fo-ci.Conclusion MRI combined with 3D CE-MRV has important clinical application in the diagnosis of primary leiomyosarcoma in infe-rior vena cava , and can replace traditional angiography and be used as the first option for the diagnosis of PIVCLMS .