原发性心脏肿瘤的影像学分析  

The imaging analysis of primary cardiac tumors

作　　者：游剑雄[1] 陈慧明[2] 张万青[3] 戴明[4] 陈中坚[4] 许家球[1] 

机构地区：[1]湛江中心人民医院放射科,广东524037 [2]湛江中心人民医院多普勒,广东524037 [3]广东医学院附属医院胸外科 [4]湛江中心人民医院胸外科,广东524037

出　　处：《影像诊断与介入放射学》2008年第6期253-256,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的分析原发性心脏肿瘤的影像学特点。方法11例经手术病理证实的原发性心脏肿瘤,包括左房黏液瘤7例,右房黏液瘤1例,右室黏液瘤1例,右房黏液肉瘤1例,心房纤维肉瘤1例,分析其胸片(正侧位或心脏常规片11例)、超声心动图(11例)、多层螺旋CT(2例)影像学表现,与手术所见及病理对照。结果胸部平片能观察房室增大及肺血改变9例,其中7例左房黏液瘤中6例均有不同程度肺淤血及左房右室增大,3例右心肿瘤均有肺血减少及右房右室增大,其中1例右房黏液肉瘤、1例右室黏液瘤并有肺动脉段突出;超声心腔团块状回声11例,肿瘤腔内房室定位、附着处、腔内病灶大小正确11例,其中黏液瘤9例见瘤蒂,活动度大,2例恶性肿瘤活动度小,9例粘液瘤均符合病理诊断;多层螺旋CT空间分辨率及密度分辨率高于超声,1例左房黏液瘤显示心房内附着于房间隔的类椭圆密度不均肿块,1例右房黏液肉瘤可观察到肿瘤侵及右房后壁。结论原发性心脏肿瘤超声心动图、胸片、多层螺旋CT的表现各有一定的特点。Objective To evaluate the various characteristic imaging manifestations of primary cardiac tumors. Methods 11 cases of cardiac tumors were collected from 1991 to 2007. All the 11 cases received surgical operation and confirmed by pathology, including 7 myxomas in left atria, 1 myxoma in right atria, 1 malignant myxosarcoma in right atria, 1 fibrosarcoma in atria, and 1 myxoma in right ventricle. 11 cases of chest radiogram, 11 of UCG, 11 of ECG, 2 cases CT scanning with contrast enhancement were performed. Results Among 11 cases, pulmonary venous congestion and heart enlargement were found in 9 cases on chest radiogram. In 7 cases of left atrial myxomas, 6 cases showed pulmonary venous congestion and left atrial, right ventricle enlargement. All the 3 cases of right atrial myxomas demonstrated reduced pulmonary venous and right atrial-ventricle enlargement. The cardiac tumors showed masses echo on UCG, with correct localizing in all the 11 cases. 9 cases of myxomas received correct diagnosis on UCG which could move widely with clear tumor pedicles, however, malignant tumors showed little movement and without pedicle. SCT was superior to UCG in spatial and density resolution. Conclusion The manifestations of primary cardiac tumors in X-ray plain film, echocardiography and SCT were of some features.

关 键 词：心脏肿瘤 X线摄影术 超声心动描记术 X线计算机 体层摄影术 诊断 

分 类 号：R732.1[医药卫生—肿瘤] R563.1[医药卫生—临床医学]