已发表论文

一个巨大下腔静脉平滑肌肉瘤病例:通过 Gadobutrol 增强 MRI 进行精准的术前评估

 

Authors Zhou X, Wang M, Li S, Cai H, Liang L, Li ZP, Feng ST, Peng Z, Li X

Received 24 April 2020

Accepted for publication 24 July 2020

Published 31 August 2020 Volume 2020:12 Pages 7929—7939

DOI https://doi.org/10.2147/CMAR.S258990

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Bilikere Dwarakanath

Background: Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumour with poor prognosis. Surgical resection is the first line of treatment to achieve the best possible outcome. However, precise preoperative evaluation is essential to guide therapeutic decisions. Here, the preoperative evaluation potential of gadobutrol-enhanced magnetic resonance imaging (MRI) was assessed in the management of a 42-year-old patient with a large IVC mass.
Methods: The patient first underwent enhanced computed tomography (CT), but the relationship between the left renal vein and the mass in the dilated IVC was ambiguous, and it remained unclear whether the right hepatic vein was invaded by the lesion. To make a precise assessment of the tumour, the patient subsequently underwent high-resolution MRI angiography examination combined with high-concentration contrast medium gadobutrol.
Results: MRI demonstrated the integrity of the right hepatic vein and the left renal vein. Following a multidisciplinary consultation, a complicated surgery including complete resection of the mass, artificial vessel replacement of IVC, total hepatectomy, and bilateral nephrectomy with liver and kidney auto-transplantation was performed successfully. The surgical plan formulated after reviewing the MRI preoperatively was adhered to the course of the surgery. Postoperative CT re-examination showed that the blood flow of the artificial blood vessel and the right hepatic vein was unobstructed. Histopathological examination confirmed the tumour to be a leiomyosarcoma.
Conclusion: Preoperative imaging diagnosis and assessment have important implications for the surgical planning of IVC leiomyosarcoma. High-resolution MRI angiography examination with high concentration contrast medium gadobutrol may be of particular benefit in IVC tumours.
Keywords: leiomyosarcoma, inferior vena cava, preoperative care, magnetic resonance imaging, gadobutrol




Figure 9 (A) Postoperative coronal enhanced venous phase CT image demonstrates patency of...