非腔内生长型原发性下腔静脉平滑肌肉瘤的CT表现及文献复习

发布时间：2018-05-27 02:20

本文选题：腔静脉 + 下　；参考：《中国全科医学》2015年03期

【摘要】：目的探讨非腔内生长型原发性下腔静脉平滑肌肉瘤(PIVCLMS)的CT表现及其诊断价值,并复习相关文献。方法选取2004—2013年台州市中心医院经手术病理证实为非腔内生长型PIVCLMS患者4例,均行CT平扫、双期增强扫描和多方位重建。结果男1例,女3例;年龄47~62岁,平均56岁;肿块直径61~113 mm,平均83.8 mm;肿块呈圆形或类圆形,边界尚清,病灶内均伴多发斑片状液化坏死区,未见钙化及出血密度;增强双期扫描肿块CT值平均升高27.4、18.5 HU。4例病灶皆起源于下腔静脉右前方,2例起源于中段(Ⅱ段),1例起源于下段(Ⅰ段),1例同时累及中段及下段,肿块紧贴下腔静脉,下腔静脉增粗但均无移位,增强扫描管腔消失被不均匀强化软组织填充,1例同时累及左肾静脉,2例伴侧支循环形成。CT所见与手术及病理结果基本相符。结论 CT扫描能客观判断肿块与下腔静脉的关系及肿块本身的影像特点,为术前正确诊断和制定合适的临床治疗方案提供可靠的依据。
[Abstract]:Objective to investigate the CT findings and diagnostic value of PIVCLMS in non-intracavitary growth type primary leiomyosarcoma of inferior vena cava. Methods four patients with non-intracavitary growth type PIVCLMS confirmed by surgery and pathology in Taizhou Central Hospital from 2004 to 2013 underwent plain CT scan dual phase enhanced scan and multidirectional reconstruction. Results there were 1 male and 3 female; the age was 47 ~ 62 years old, mean 56 years old; the diameter of the mass was 61 ~ 113mm with an average of 83.8 mm; the mass was round or round, the boundary was still clear, and the lesion was accompanied with multiple flake liquefaction necrosis area without calcification and bleeding density. The mean CT value of enhanced dual phase CT was 27. 4 or 18. 5 HU.4. All lesions originated from the right anterior inferior vena cava in 2 cases (2 cases from the middle segment of the inferior vena cava) (1 case from the lower segment (1 case from the middle and lower segment of the first segment), and the mass was closely attached to the inferior vena cava (IVC), and the lesions were closely related to the inferior vena cava (IVC). The inferior vena cava was thickened but no shift was found. The disappearance of enhanced lumen was filled with inhomogeneous enhanced soft tissue in 1 case and the left renal vein in 2 cases with collateral circulation formation. Ct findings were in good agreement with the surgical and pathological results. Conclusion CT scan can objectively judge the relationship between the mass and the inferior vena cava and the imaging characteristics of the tumor itself, and provide reliable basis for the correct diagnosis before operation and the formulation of appropriate clinical treatment plan.
【作者单位】：浙江省台州市中心医院影像中心;
【分类号】：R730.44;R732.2

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