Diagnostic experience of intravenous leiomyomatosis with emphasis on conventional ultrasonography imaging: a single-center study

Objective Intravenous leiomyomatosis (IVL) is a rare and aggressive tumor type that has the potential to extend into inferior vena cava (IVC) susceptible be misdiagnosed neglected. Despite its clinical significance, there paucity of research focused on specific manifestations IVL ultrasonography. Therefore, this study aims systematically analyze ultrasound features augment diagnostic accuracy. Materials method Prospective inclusion was granted patients admitted our hospital between December 2016 March 2021 for an IVC-occupying lesion. Multi-modal ultrasonography, encompassing gray-scale color Doppler, conducted. Lesions were categorized as or non-IVL based pathological follow-up data. Two sonographers with over 5 years experience read recorded data all lesions, which subsequently comparatively analyzed identify signs IVL. Results A total 284 diagnosed lesions included in study. The lesion types comprised (n=67, 23.6%), IVC thrombus (n=135, 47.5%), renal carcinoma involving (n=35, 12.4%), liver (n=24, 8.5%), leiomyosarcoma (n=14, 4.9%), adrenocortical adenocarcinoma (n=9, 4.1%). presence “sieve hole” “multi-track” observed 20 under grey-scale modality, while both absent group ( P <0.01). found no statistically significant differences presentation Doppler modalities cases intravascular lithotripsy >0.05). Using these two criteria IVL, sensitivity, specificity, positive predictive value (PPV), negative (NPV), miss rate, misdiagnosis accuracy determined 29.9%, 100%, 82.2%, 70.1%, 0, 83.5%, respectively (AUC ROC=0.649; 95%CI: 0.537-0.761). Conclusion exhibits distinct presentations, including signs, demonstrate high specificity indicators. Furthermore, are corroborated by evidence effectively distinguish from other occupying IVC.