心肌心包肿瘤的影像学评价和探讨  

Imaging study and evaluation in myocardiac and pericardical tumors

作　　者：陈剑魂[1] 邝健谊[1] 杨辉 绪光 吴妙玲[1] 

机构地区：[1]中山医科大学附属第一医院放射科,510080

出　　处：《中国临床医学影像杂志》1999年第2期89-92,共4页Journal of China Clinic Medical Imaging

摘　　要：评价影像学对心肌心包肿瘤的应用及分析其影像学表现。材料与方法：经证实28例除1例良性心包血管瘤外，其余均为恶性。原发性8例，转移性19例。临床表现为心脏填塞症状与体征。20例血性心包积液。进行胸部平片。超声心动图、心电图、CT直接增强扫描、MRI检查。结果：①良性心包肿瘤MRI清楚显示心包扁平肿物伴纤维包膜，界限清晰，TWI，TZWI呈均匀中等信号；②恶性：CT和MHI心包或心肌常见到不规则增厚或多个结节影突出，后者致心腔不均匀缩小变形，前者多伴有心包积液。超声心动图有时亦见到上述证象，但胸部平片仅示心影扩大。结论：①影像学（尤其是MHI）常能提供心肌心包肿瘤的定位定性诊断；②心肌与心包肿瘤的鉴别在于前者多伴有心腔不规则变形缩小，而后者多有心包积液。良恶性区别常在于肿物境界与密度（信号）均匀与否；③本病鉴别诊断包括感染性和外伤性心包炎，粘液瘤，血栓以及局限性心肌肥厚（如肥厚型心肌病）等。Objective: To evaluate imaging usefulness and analyse imaging featares in myocedac and pericardical tumors. Materiais and Methods: Of 28 cases confirmed by pathology, benignant 1 case, malignant 27 cases (primaxy 8, metastasis 19) hadheart tamponade symptoms and signs clinically, 20 eases of bloody hydripericwhium. Chest radiogram, UCG, ECG, CT scanning with contrastenhancement and MRI were performed. Results : ①Benignant pericardial tumor: MRI revealed a clear flat soft mass with fibrous capsule, homogeneous intermediate signals of T1 WI and T2 WI; ②malignant tumor: On CT and MRI myocardiac tumor showed mere nodules or irregularthicken of myocardiac wall and irregular reduce, deformation of the heart cheder, while pericardial tumor was more nodules with hydropericardium . In some petients UCG also presented above findings but only enlarged heart shadows on chest radiogram. Conclusion: ①The location and the property of heart tumors can be detected by imaging espeially MRI; ② The differential between myocardiac and pericedal tumor was irregular and narrow of the heart chedr in the forme, but with pericedal effusion in the latter. The malignant tumoralways appear to be poor margins and uneven density or signal; ③The different diagnosis with the tumor includes infectious and traumaticpeticarditis, myxoma, thrombus and local hypertrophic myocardiosis.

关 键 词：心脏肿瘤 CT MRI 诊断 

分 类 号：R732.1[医药卫生—肿瘤]