静脉内平滑肌瘤一例并文献复习

Intravenous leiomyomatosis:A case report and review of the literature

目的静脉内平滑肌瘤(intravenous leiomyomatosis,IVL)因无特异性临床症状及体征,早期临床诊断比较困难。本研究探讨IVL的MRI表现,以期为其早期诊断提供可靠影像学依据。方法选取2018-05-03济宁市第一人民医院经手术病理确诊的1例IVL患者的临床及影像资料,并对相关文献进行复习。结果 MRI显示,盆腔内子宫旁巨大囊实性不规则形迂曲软组织肿块,与子宫交界面边界不清晰;平扫T1WI呈等低信号,T2WI呈不均匀高信号,囊变区呈更高信号,DWI未见扩散受限;增强扫描肿瘤明显不均匀强化,与子宫交界处可见多发迂曲流空血管影。结论 MRI检查对于IVL的准确诊断有显著帮助,但最终确诊仍需要病理学检查。

OBJECTIVE The leiomyosarcoma has no specific clinical symptoms and signs,and early clinical diagnosis is difficult.This article aims to investigate the MRI findings of intravenous leiomyomatosis in order to provide a reliable imaging basis for the early diagnosis of venous leiomyomatosis.METHODS A retrospective analysis of a clinical and imaging data of patients with intravenous leiomyomatosis confirmed by surgery and pathology at Jining First People′s Hospital on May 3,2018,and reviewing relevant literature.RESULTS The patient′s MRI showed a large cystic solid irregular soft tissue mass around the uterus in the pelvic cavity,the boundary between the mass and uterus was not clear.Plain scan T1 WI showed iso-low signal,T2 WI showed heterogeneous high signal,cystic zone showed higher signal,DWI was not diffusion-restricted.On contrast-enhanced scan,the tumors were markedly unevenly enhanced and multiple tortuous empty vessels were seen at the junction of uterus and uterus.CONCLUSION MRI is helpful for the accurate diagnosis of IVL,but the final diagnosis still needs pathological examination.