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CT及MRI诊断子宫平滑肌瘤病累及下腔静脉及右心腔 总被引:1,自引:1,他引:0
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。 相似文献
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正静脉内平滑肌瘤病(intravenous leiomyomatosis,IVL)是一种具有不良生物学行为的特殊类型子宫肌瘤,其中有10%~30%的肿瘤累及下腔静脉、右心腔及肺动脉,成为心脏内平滑肌瘤病(intracardi-ac leiomyomatosis,IVL)~([1])。以下腔静脉或右心房病变为首发症状,该病发展极为隐袭,临床表现多样且缺乏特异性,诊断非常困难~([2])。本科于2015年6月收治1例静脉内平滑 相似文献
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子宫静脉内平滑肌瘤病临床病理及免疫表型分析 总被引:3,自引:0,他引:3
目的 探讨子宫静脉内平滑肌瘤病(IVL)的临床生物学行为、病理学特点及其免疫表型的临床意义.方法 应用免疫组化方法 检测子宫IVL肿瘤细胞vimentin、desmin、SMA、CD10、CD34、ER和PR的表达情况.结果 6例患者术前均诊断为子宫多发性平滑肌瘤,未曾怀疑为IVL;3例行全子宫切除术,3例行全子宫及双侧附件切除术,其中1例术中见灰白色条索样肿物蔓延致右侧宫角和宫旁组织静脉内;病理检查发现6例标本除合并血管外子宫平滑肌瘤外,子宫肌壁间大小不一的静脉内见平滑肌细胞构成的瘤栓.6例患者经随访6~51个月未见复发.免疫组化染色显示,IVL瘤细胞vimentin、desmin和SMA(+),CD10和CD34(-);其中5例肿瘤细胞ER和PR呈强(+),1例呈(+).结论 IVL是组织学表现为良性却具有类似恶性肿瘤生长方式的一类罕见肿瘤,有远期复发的倾向.IVL肿瘤细胞存在雌、孕激素高表达特性,提示卵巢去势治疗或术前、术后应用雌激素拮抗剂可能是有效的辅助治疗手段. 相似文献
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Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor. Although IVL is histologically benign, it might be aggressive in its behavior and can grow into pelvic veins and the inferior vena cava (IVC) extending into the heart chambers and pulmonary vasculature. Occasionally, it was found to have lung metastasis. We describe four cases of IVL in the IVC with a history of hysterectomy for uterine leiomyoma, one extending into the left renal vein and three growing into the right heart chamber. We report the computed tomography (CT) findings in the four cases and briefly discuss the CT features of IVL in order to help making accurately preoperative diagnosis and improve the rate of surgical resection and survival. 相似文献
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超声诊断静脉内平滑肌瘤病(附7例报告) 总被引:1,自引:0,他引:1
目的 回顾性分析静脉内平滑肌瘤病(IVL)的超声表现,提高对IVL的认识和诊断水平.方法 回顾性分析7例经手术病理证实确诊为IVL临床资料,总结所累及脏器的超声表现.结果 7例均为女性,6例有子宫肌瘤病史,5例已行子宫切除手术,1例超声见子宫肌壁间多发结节及盆腔多发肿物.7例血管彩色多普勒超声均发现一侧髂内静脉伴髂外静脉或髂总静脉占位,并见下腔静脉不同段实性中等回声占位:4例累及下腔静脉下段;3例累及下腔静脉全程,其中2例向上延伸至右心房.结论 IVL的临床表现复杂多样,超声表现有一定的特点,掌握IVL超声特点有助于提高诊断正确率. 相似文献
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S Boopathy Vijayaraghavan Vaijayanthi Raja T V Chitra 《Journal of ultrasound in medicine》2003,22(7):747-752
An interrupted inferior vena cava (IVC) and a left-sided subrenal (postrenal) IVC with azygos or hemiazygos continuation are very rare anomalies of the IVC. The prenatal sonographic and color Doppler features of these anomalies are reported here. 相似文献
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目的探究下腔静脉(IVC)超声指标对接受维持性透析的慢性肾衰竭合并高血压患者的容量状态评估价值。方法纳入我院肾内科拟接受维持性透析治疗的慢性肾衰竭合并高血压的患者56例,根据CT心胸比值将患者分为容量过负荷组和容量正常组,于透析治疗前使用床旁超声动态监测下腔静脉内径(D-IVC),并计算下腔静脉随呼吸变异度(V-IVC)。观察并分析两组间各指标的差异。通过受试者工作特征(ROC)曲线评价各指标对容量状态的预测价值。并将呼气末下腔静脉内径(D-IVCe)、V-IVC分别与CT心胸比进行相关性分析。结果容量过负荷组较容量正常组具有较高的D-IVCe(P=0.005)和较低的V-IVC(P=0.01)。以D-IVCe和V-IVC分别取17.7mm和30%为阈值,预测容量过负荷的敏感度为58.3%和81.3%,特异度为81.2%和58.3%,ROC曲线下面积分别为0.719(95%CI:0.584~0.855)和0.696(95%CI:0.554~0.838)。相关性分析显示,CT心胸比与D-IVCe呈正相关性(r=0.607),与V-IVC呈负相关性(r=-0.585)。结论下腔静脉超声指标对慢性肾衰竭合并高血压的维持性透析患者容量状态有较好的评估价值。 相似文献
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目的:评价自然组织谐波显像技术(NTHI)测量左室收缩功能的准确性。方法:利用测定20例患者的左室容量和射血分数,并与左室造影的测值进行比较。结果:NTHI所测左室容量和射血分数与左室造影相应测值高度相关,左室舒张末期容量和收缩末期容量及射血分数的相关系数分别为0.87,0.96,0.92。NTHI左室容量测值低估约30%。结论:超声NTHI技术能准确可靠测定左室容量和射血分数,为评价左室收缩功能提供简便易行的方法。 相似文献
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C Berg A Geipel J Smrcek M Krapp U Germer T Kohl U Gembruch A A Baschat 《Ultrasound in obstetrics & gynecology》2003,22(5):451-459
OBJECTIVE: To assess the accuracy of fetal echocardiography in the prenatal diagnosis of cardiosplenic syndromes and the spectrum of associated anomalies. METHODS: This was a retrospective survey of fetuses in our databases over a period of 10 years with postnatally confirmed prenatal diagnosis of cardiosplenic syndromes. RESULTS: In 32 of 35 fetuses the prenatal diagnosis of cardiosplenic syndromes was confirmed postpartum. Twenty-two fetuses had left isomerism. Their main prenatal ultrasound features were interrupted inferior vena cava (n = 21), complete atrioventricular septal defect (n = 15), viscerocardiac heterotaxy (n = 15), persistent bradyarrhythmia (n = 12) and fetal hydrops or nuchal edema (n = 12). Twelve pregnancies were terminated, two fetuses were stillborn and eight infants survived. Ten fetuses had right isomerism. Their main sonographic features were juxtaposition of the descending aorta and inferior vena cava (n = 7), complete atrioventricular septal defect (n = 7), left persistent superior vena cava (n = 6) and viscerocardiac heterotaxy (n = 6). In this group there was one stillbirth, five infant deaths and four survivors. The overall survival rate and spectrum of other cardiac malformations were similar between the two groups. Prenatal diagnosis of other visceral features of cardiosplenic syndromes was inconsistent. CONCLUSION: Cardiosplenic syndromes can be diagnosed with high accuracy by prenatal sonography. A diagnosis of left isomerism should be strongly suggested in the presence of a combination of at least two of the following: (1) complete atrioventricular septal defect or other structural heart disease; (2) interruption of inferior vena cava with azygos continuation; (3) early fetal heart block; (4) viscerocardiac heterotaxy. Right isomerism should be suspected in the presence of a combination of at least two of the following: (1) structural heart disease, namely complete atrioventricular septal defect; (2) juxtaposition of inferior vena cava and descending aorta; (3) viscerocardiac heterotaxy. 相似文献
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Primary tumors of the inferior vena cava (IVC) are rare. The most common primary malignancy is leiomyosarcoma (LMS), with a severe prognosis. Right‐atrium (RA) involvement is seen in about 20 percent of cases. We report the case of a 53‐year‐old woman admitted to the intensive care unit because of progressive dyspnea with lower limb edema. Echocardiography demonstrated a large mass in the RA. At open‐heart surgery, the tumor appeared located in the IVC infrahepatic segment, completely obstructing the lumen and extending into the suprahepatic portion and the RA. Histopathological examination concluded to LMS. 相似文献
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Haest RJ van den Berg CJ Goei R Baur LH 《The international journal of cardiovascular imaging》2006,22(3-4):565-568
Scimitar syndrome a very rare and variable congenital disorder characterized by an anomalous connection of the pulmonary vein with the IVC. The syndrome is mostly seen in very early infancy, but was now recognized in a 46-year-old woman, who was referred to the outpatient clinic of the department of cardiology with complaints of dizziness. Contrast enhanced computer tomography (CT) showed dextroposition of the heart and a large right pulmonary vein joined the inferior vena cava (IVC) just above the level of the diaphragm. The typical features of the syndrome are discussed. 相似文献
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Sonography and Transthoracic Echocardiography for Diagnosis of Systemic Cardiovascular Metastatic Tumor Thrombi 下载免费PDF全文
Jiong Wang MD Yi Cheng MD PhD Yueh Z. Lee MD PhD Yongmei Wang MD Ye Zheng MD Ran Dong MD Yongqiang Lai MD PhD Xiaobin Tang MD Yaoguo Yang MD PhD Sheng Wang MD Nan He MD Yunfeng Jia MD Wei Cheng MD Dan Liu MD PhD Xiaona Wang MD Chun Zhang MD 《Journal of ultrasound in medicine》2016,35(9):1993-2027
Sonography and transthoracic echocardiography (TTE) are seldom used for assessment of metastatic tumor thrombi in the cardiovascular system in routine clinical practice. We performed this retrospective study to evaluate the combination of sonography with TTE for diagnosis of metastatic tumor thrombi in heart and systemic vessels. Vascular, abdominal, pelvic, and small‐part sonography was applied in 18 patients, and TTE was conducted simultaneously in 14 patients. Tumor thrombi invaded into the inferior vena cava system in 12 patients, superior vena cava system in 5 patients, and aorta in 1 patient; they extended to the right cardiac chambers in 11 patients. Six patients had diagnoses by pathologic examination. The primary neoplasms were identified by conventional imaging in 17 patients. The morphologic and echogenic characteristics of the tumor thrombi were diverse and depended on their original tumors. The thrombi were either contiguous or discrete from the original tumors. The neoplastic vascularity of the thrombi and the invasive extension were the primary characteristics that distinguished them from bland thrombi. Simultaneous application of sonography and TTE is a feasible way to comprehensively evaluate cardiovascular metastatic tumor thrombi in most patients. 相似文献
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Luke J. Laffin Amit V. Patel Narayan Saha Julian Barbat James K. Hall Matthew Cain Kishan Parikh Jay Shah Kirk T. Spencer 《The international journal of cardiovascular imaging》2018,34(7):1075-1079
Acute decompensated heart failure (ADHF) is a common reason for admission to the hospital, and readmission is frequent. Multiple factors contribute to rehospitalizations, but inadequate assessment of volume status leading to persistent congestion is an important factor. We sought to determine if focused cardiac ultrasound (FCU) of the inferior vena cava (IVC), as a surrogate of volume status, would predict readmission of ADHF patients after index hospitalization. Patients admitted with a primary diagnosis of ADHF were prospectively enrolled. All patients underwent FCU of the IVC on admission and then daily. 82 patients were enrolled. Patients demonstrated improvement in heart failure physical examination findings and symptoms during the hospitalization. There was a reduction in the size of the IVC and a significant increase in patients with small collapsible vena cava. Logistic regression analysis of physical examination, patient symptoms, and IVC parameters at discharge demonstrated IVC collapsibility and patient reported dyspnea improvement as the only significant variables to predict readmission or emergency department visit. FCU assessment of IVC size and collapsibility may be useful in patients with ADHF to predict risk of being readmitted within 30 days of hospital discharge. 相似文献