CT及MRI诊断子宫平滑肌瘤病累及下腔静脉及右心腔

摘要

目的 观察子宫平滑肌瘤病累及下腔静脉及右侧心腔的CT及MRI影像学表现.方法 收集8例病理诊断为子宫平滑肌瘤病累及下腔静脉及右侧心腔患者,回顾性分析术前CT及MRI表现.结果子宫平滑肌瘤病累及下腔静脉及右侧心腔CT及MRI影像学特点:病灶大部分游离于静脉或心腔内,中等不均匀强化,病变与子宫静脉平滑肌瘤原发灶或复发灶相延续;累及右心腔时可见似"拐杖头"或"蛇头"状改变.子宫平滑肌瘤病的特异性表现为子宫或宫旁血管增粗、纡曲成团.结论 CT及MRI不仅可显示子宫平滑肌瘤病累及下腔静脉及右心受累范围,同时可以检出盆腔原发或复发病变,对指导治疗及评价预后有重要意义.%Objective To observe CT and MRI manifestations of uterine leiomyomatosis involving the inferior vena cava and the right cardiac cavity. Methods Eight patients with pathologically diagnosed uterine leiomyomatosis involving the inferior vena cava and right heart chamber were enrolled, and their preoperative CT and MRI data were analyzed retrospectively. Results CT and MRI images showed that the majority of the lesion floated in the vein or heart cavity and connected with the primary or recurrence lesions with moderate heterogeneous enhancement. When the right heart was involved, it looked like "walking stick head" or "snakeheads". Dilated and tortuous blood vessels could be found around the primary or recurrent uterine leiomyomatosis, which was the specific feature of uterine leiomyomatosis. Conclusion CT and MRI can not only observe the range of uterine leiomyomatosis involving the inferior vena cava and the right cardiac cavity, but also detect the primary or recurrent pelvic diseases, therefore are important to the treatment and prognostic evaluation.