Blum U, Wildanger G, Windfuhr M, Laubenberger J, Freudenberg N, Munzar T
Department of Diagnostic Radiology, University Hospital Freiburg, Germany.
Eur J Radiol. 1995 May;20(1):23-7. doi: 10.1016/0720-048x(95)00608-s.
We investigated the radiological findings of five patients with primary leiomyosarcoma of the inferior vena cava (IVC) comparing cavography, computed tomography (CT), and magnetic resonance imaging (MRI). The radiographic presentation ranged from an intraluminal lesion with obstruction of the IVC to a tumor mass extending from the media musculature into the surrounding perivascular tissue with only slight protrusion into the lumen. The lesions were associated with late or few symptoms. Pathognomonic radiological findings could not be established. In cases with an extraluminal growth a lobulated, well-defined, encapsulated tumor with an inhomogeneous contrast uptake is characteristic in CT studies. Additional information was provided by MRI. Leiomyosarcomas with extraluminal involvement showed homogeneous intermediate signal intensity (SI) on T1-, and mixed intermediate/high SI on T2-weighted images. In cases with predominantly intraluminal growth, both CT and MRI demonstrated the IVC to be dilatated and allowed to differentiate between tumor extent and obliterating thrombosis. Modern imaging modalities allow an early and accurate pre-operative diagnosis resulting in a higher rate of surgical resection and improvement of survival.
我们对5例原发性下腔静脉平滑肌肉瘤患者的影像学表现进行了研究，比较了腔静脉造影、计算机断层扫描（CT）和磁共振成像（MRI）的结果。影像学表现范围从下腔静脉腔内病变伴管腔梗阻到肿瘤肿块从血管中层肌肉组织延伸至周围血管周围组织，仅轻微突入管腔。这些病变相关症状出现较晚或较少。未发现具有诊断意义的影像学表现。在腔外生长的病例中，CT检查显示为分叶状、边界清晰、有包膜的肿瘤，对比剂摄取不均匀。MRI提供了更多信息。腔外受累的平滑肌肉瘤在T1加权像上表现为均匀的中等信号强度（SI），在T2加权像上表现为中等/高混合信号强度。在主要为腔内生长的病例中，CT和MRI均显示下腔静脉扩张，并能区分肿瘤范围和闭塞性血栓形成。现代成像方式可实现早期、准确的术前诊断，从而提高手术切除率并改善生存率。
