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目的探讨子宫平滑肌瘤病经静脉延伸至右侧心腔的影像学特点及诊断。方法对5例子宫平滑肌瘤病经静脉延伸至右侧心腔的病例进行回顾分析,5例均行胸部X线平片、超声心动图,3例行电子束CT(EBCT)检查,2例行MRI和DSA检查。结果3例行EBCT检查者中2例诊断为子宫平滑肌瘤(肉瘤可能),肿瘤经静脉延伸至右侧心腔并侵及肺动脉(1例病理诊断为子宫平滑肌瘤病,1例未手术),另1例诊断为子宫平滑肌瘤经静脉延伸至右侧心腔(未手术);2例行MR和DSA检查诊断为子宫平滑肌瘤经静脉延伸至右侧心腔。5例患者中3例病理诊断为平滑肌瘤病。结论子宫平滑肌肿瘤可以经静脉延伸至右侧心腔,罕见,称为子宫平滑肌瘤病,临床有一定特点。CT、MRI、DSA有相应的征象,影像学表现常呈生物学恶性征象,但积极手术治疗仍可得到良好临床效果。
Objective To investigate the imaging features and diagnosis of uterine leiomyomatoid vein extending to the right heart chamber. Methods Five cases of leiomyoma of the uterus were retrospectively analyzed by venous extension to right ventricle. Five cases underwent chest radiography, echocardiography, three cases were examined by electron beam computed tomography (EBCT), two cases MRI and DSA examination. Results Two of the three cases of EBCT were diagnosed as uterine leiomyoma (sarcoma may be), the tumor extended to the right heart chamber through the vein and invaded the pulmonary artery (one case was pathologically diagnosed as uterine leiomyomata, one case without surgery ), And the other one was diagnosed as uterine leiomyoma by vein extension to the right heart chamber (no surgery); 2 cases of MR and DSA examination diagnosed as uterine leiomyomas by vein extension to the right heart chamber. Three of the five patients were pathologically diagnosed as leiomyomata. Conclusion Uterine smooth muscle tumors can be extended to the right ventricle vein, rare, known as uterine leiomyoma, clinical features. CT, MRI, DSA have the corresponding signs of radiological manifestations of often malignant biological signs, but active surgical treatment can still get good clinical results.