PDF(Pubmed)
Abstract：
A 43-year-old patient with a history of uterine fibromatosis was referred to our hospital for menometrorrhagia and pelvic pain. At the pelvic ultrasound, a highly-vascularized myometrial lesion in volumetric increase was described. An elongated, solid, hypoechoic, painless, and highly vascularized left parauterine mass was identified. On histological examination, a uterine smooth muscle tumor of uncertain malignant potential (STUMP) with intravascular invasion of the left uterine vein was diagnosed. The adnexa and peritoneum were free of disease. On a retrospective evaluation of the ultrasound images, we noticed that the intravascular lesion showed sonographic features comparable to the original mass. Moreover, the Color Doppler (CD) analysis revealed an interrupted blood flow within the left uterine vein. In this case, the ultrasound proved to be an accurate diagnostic tool. When inhomogeneous uterine masses are suspected, and a parauterine/paraadnexal mass surrounded by irregular vessels are identified, the sonographer should take into account a risk of intravascular invasion. The patency of uterine and ovarian vessels should be accurately evaluated, to guide a tailored patient surgical approach.
摘要：
一名43岁有子宫纤维瘤病病史的患者因月经过多和盆腔疼痛被转诊到我院。在盆腔超声检查中，描述了体积增加的高度血管化的子宫肌层病变。细长的，固体,低回声,无痛,发现了高度血管化的左子宫旁肿块。在组织学检查中，诊断为恶性潜能不确定的子宫平滑肌肿瘤(STUMP),血管内侵犯左子宫静脉.附件和腹膜无疾病。在对超声图像的回顾性评估中，我们注意到血管内病变的超声特征与原始肿块相当.此外，彩色多普勒（CD）分析显示左子宫静脉内血流中断。在这种情况下,超声波被证明是一种准确的诊断工具。当怀疑子宫肿块不均匀时，并识别出被不规则血管包围的子宫旁/附件旁肿块，超声医师应考虑血管内侵犯的风险。应准确评估子宫和卵巢血管的通畅，指导量身定制的患者手术方法。
