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. 2024 Jun 1;14(6):4281-4287.
doi: 10.21037/qims-23-1772. Epub 2024 May 8.

Multimodality imaging applications in the diagnosis of and surgical treatment strategy for intravenous leiomyomatosis: a case description and literature analysis

Jie Zhao #  1   2 , Jia Liao #  2   3 , Wenliang Fan #  1   2 , Qun Yu  1   2 , Ziqiao Lei  1   2
Affiliations

Multimodality imaging applications in the diagnosis of and surgical treatment strategy for intravenous leiomyomatosis: a case description and literature analysis

Jie Zhao et al. Quant Imaging Med Surg. .
No abstract available

Keywords: Cardiac; cine; diastole; mass; systole.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1772/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Contrast-enhanced computed tomography scans. The coronal reconstruction (A), sagittal reconstruction (B), and volume rendering (C) images showed a cord-like mass (arrows) in the lumen of the left ovarian vein, extending to the inferior vena cava and right atrium. Varicosity and dilatation of the left genital vein were observed (triangles). No significant enhancement was observed in the enlarged uterus.
Video 1
Video 1
Cardiac magnetic resonance imaging cine of the four chambers revealed that the mass in the atrium traversed the outflow tract from the right atrium to the right ventricle during diastole, and returned during systole.
Video 2
Video 2
Sagittal cardiac magnetic resonance imaging cine revealed that the mass ascended from the inferior vena cava into the right atrium, exhibiting regular movement with the cardiac cycle and protruding into the right ventricle during diastole.
Figure 2
Figure 2
Gadolinium-enhanced magnetic resonance imaging scans. The enhancement of the cord-like mass was more discernible on the magnetic resonance images than the computed tomography scans due to the superior soft tissue contrast (arrows), and linear filling defects were also prominently visible. An inhomogeneously enhanced, enlarged soft tissue mass was identified on the anterior wall of the uterus (triangles). (A) Coronal reconstruction. (B) Oblique-sagittal reconstruction. (C) Maximum intensity projection in magnetic resonance angiography.
Figure 3
Figure 3
Magnetic resonance axial images and pathological images. (A) Axial T2-weighted imaging showing a lesion with low signal intensity in the IVC (triangle). (B) On the axial T1-weighted images, the lesion in the IVC exhibited moderate signal intensity (triangle). (C) The enhanced axial T1-weighted fat-suppressed images demonstrated pronounced enhancement of the lesion in the IVC, characterized by a sieve-pore appearance (triangle). (D) On the axial T1-weighted fat-suppressed enhanced images, a lesion in the left renal vein demonstrated marked enhancement, resembling a sieve pore (triangle). (E) A gross pathological specimen showed a cord-like mass. (F) The histopathological analysis confirmed the cord-like mass to be intravenous leiomyomatosis (hematoxylin and eosin staining, ×100 magnification). IVC, inferior vena cava.
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References

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