左心房血栓与黏液瘤的多层CT诊断  

Multi-slice CT Diagnosis of Thrombus and Myxoma in the Left Atrium

作　　者：祝因苏[1] 唐立钧[1] 徐怡[1] 朱晓梅[1] 徐海[1] 

机构地区：[1]南京医科大学第一附属医院放射科

出　　处：《中国医学计算机成像杂志》2014年第1期25-28,共4页Chinese Computed Medical Imaging

基　　金：江苏高校优势学科建设工程资助项目(JX10231801)~~

摘　　要：目的：研究左心房血栓及黏液瘤的CT特征，以提高其诊断准确率。方法：回顾性分析经病理学检查证实的左心房黏液瘤及血栓各5例（男5例，女5例，年龄19～75岁），采用双源CT心电门控采集，完成平扫和冠脉CTA检查，并进行图像后处理显示病变。结果：黏液瘤均单发，病灶附着于左心房壁，为不规则椭圆形，平扫呈软组织密度，4例密度不均匀，3N合并斑点状及条片状钙化，增强后4例呈明显不均匀强化，1例为轻中度不均匀强化。1例多发血栓发生于左心房内及心耳，其余4例单发，3N椭圆形，1例不规则形，其中2例呈铸型位于左心耳；5例均密度均匀，未见钙化；增强后4例病灶不同程度强化，2例不均匀，2例均匀，1例未见明显强化。结论：左心房黏液瘤和血栓多层CT显示良好，有一定特征性，但确诊有赖于病理。Purpose： To analyze multi-slice CT （MSCT） appearances of the thrombus and myxoma in the left atrium, and to improve the recognition of them. Methods： MSCT appearances of 5 thrombus and 5 myxomas in the left atrium, which were pathologically proved through operation, were reviewed retrospectively. And their characteristics were summarized. Results： There were 3 male and 2 female patients with myxoma, while 2 male and 3 female patients with thrombus. Among patients with myxoma, the lesions were solitary and adhered to the left atrium wall with a irregular oval shape. Four of them showed inhomogeneous soft density with spot and strip calcification and with obviously heterogeneous enhancement, while one of them was found with slight heterogeneous enhancement. Among patients with thrombus, the lesions were solitary except one case had two lesions in the left atrium and its appendage with oval shape in 3 cases and irregular shape in 2 cases. Four of them showed varying degrees enhancement, including 2 cases obviously heterogeneous enhancement, while one of them was found no enhancement. Conclusion： MSCT can not only provide accurate assessment of the size, location, shape, movement, attachment and enhancement pattern of the thrombus and myxoma in the left atrium, but also have important qualitative diagnostic advantage. The final diagnosis should be confirmed by operation and pathology.

关 键 词：左心房 体层摄影术 X线计算机 血栓 黏液瘤 

分 类 号：R732.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]