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目的:探讨子宫静脉内平滑肌瘤病(IVL)的临床和影像特点,增进对该病的认识。方法:回顾性分析我院近5年3例伴有下腔静脉及右心受累的子宫静脉内平滑肌瘤病,对其临床特点、影像表现、治疗及预后进行总结。结果:3例患者中2例既往有子宫肌瘤切除史,1例首次发病。2例因下肢水肿、夜间呼吸困难,1例因左协肋部不适发现肾盂积水就诊。CT扫描均发现腹盆腔巨大肿块,表面分叶状,增强多发结节样强化,同时见盆腔静脉增多增粗,静脉内瘤栓形成并经髂内静脉、髂总静脉蔓延至下腔静脉,1例达右心房并引起肝淤血表现。结论:IVL是少见变异的子宫肌瘤,病变可由盆腔静脉向上蔓延至下腔静脉甚至右心房,对生命造成一定威胁,应提高对IVL的认识。
Objective: To investigate the clinical and imaging features of uterine venous leiomyomatosis (IVL) and to improve their understanding of the disease. Methods: A retrospective analysis of 3 cases of uterine venous leiomyomatosis complicated with IVC and right heart in our hospital in the past 5 years was made. The clinical features, imaging findings, treatment and prognosis were summarized. Results: Two of the three patients had a history of myomectomy and one had the first history of myomectomy. 2 cases of edema due to lower extremity, difficulty breathing at night, 1 case of hydronephrosis due to left unilateral joint discomfort found. CT scan found a huge abdominal mass, lobulated surface, enhanced nodular enhancement, while see the pelvic vein increased thickened, intravenous tumor thrombus formation and the iliac vein, common iliac vein spread to the inferior vena cava, 1 Cases of right atrium and cause liver congestion. Conclusion: IVL is a rare variant uterine fibroids. The lesions can spread from the pelvic veins to the inferior vena cava or even to the right atrium, posing a threat to life and raising the awareness of IVL.