【摘要】 目的探讨盆腔区域子宫静脉内平滑肌瘤病(IVL)的超声特征,以提高对该病的超声诊断水平。方法回顾性分析2016年2月至2020年12月本院收治的4例经手术证实的盆腔区域IVL患者临床、超声及病理资料。结果患者平均年龄44岁,2例有子宫肌瘤剔除术病史。3例超声提示子宫及附件区实性"蠕虫样"占位,术前提示IVL。1例漏诊病例,超声仅提示子宫肌瘤。术中瘤体呈条索状分布,沿子宫血管生长,与超声所见相符。结论盆腔区域IVL的超声声像图表现具有一定特征性,对比历史检查如发现"蠕虫样"实性结节可提示IVL可能;超声能显示病变大小、累及范围、内部回声及血流等情况,可作为IVL术前诊断及术后随访的首选影像学方法。更多还原

【Abstract】 Objective To analyze the ultrasonographic features of intra pelvic intravenous leiomyomatosis(IVL) and improve its diagnosis. Methods Clinical data and ultrasonography imaging of 4 patients with pathologically confirmed intra pelvic IVL in our hospital from February 2016 to December 2020 were retrospectively analyzed. Results The mean age of 4 patients was 44.2 patients had a history of hysteromyomectomy. 3 cases showed "worm like" solid masses in uterus and adnexa by ultrasound, and IVL was indicated before operation;1 case was missed diagnosis, and only hysteromyoma was indicated.The pathological manifestation was smooth muscle cell grow along the blood vessels, which was consistent with the ultrasonographic findings. Conclusion The ultrasonographic manifestations of IVL in pelvic region have certain characteristics. The "wormlike" solid nodules found in comparative historical examination may indicate the possibility of IVL. Ultrasound can display the size, scope of involvement, internal echo and blood flow of the lesion, which can be used as the preferred imaging method for preoperative diagnosis and postoperative follow-up of IVL.更多还原