心脏粘液瘤的MRI表现特征  

The MRI Manifestations of Cardiac Myxoma

作　　者：陈晓荣[1] 舒锦尔[1] 潘勇浩[1] 徐甜甜[2] 胡红杰[2] 

机构地区：[1]浙江大学金华医院医学影像科,321000 [2]浙江大学医学院附属邵逸夫医院放射科,310016

出　　处：《临床放射学杂志》2017年第5期654-657,共4页Journal of Clinical Radiology

基　　金：金华市科学技术局社会发展类重点项目(编号:2014-3-009)

摘　　要：目的探讨心脏粘液瘤的MRI表现特征。方法搜集18例经手术及病理确诊的心脏粘液瘤患者资料,术前均行心脏MRI增强检查,采集心脏粘液瘤的电影序列、SE序列(T1WI、T2WI)或IR序列(Double IR、Tripple IR)、首过灌注及延迟增强序列图像,对心脏粘液瘤的数量、位置、大小、边缘、MRI信号特点、基底及运动特点、强化特点、心脏结构改变、血流动力学特点等影像表现特点进行分析。结果 18例心脏粘液瘤位于左心房者14例。10例肿瘤起源于房间隔,6例起源于心房的游离壁,2例起源于心室壁。9例肿瘤可见瘤蒂,9例肿瘤的基底较宽。10例粘液瘤表现为圆形或椭圆形,8例表现为分叶状。所有粘液瘤的电影序列信号都为低信号,低于心肌信号,T2WI序列或Tripple IR序列整体都表现为高信号或等高信号,明显高于心肌信号,3例可见内部混杂点状低信号。首过灌注皆表现为充盈缺损,6例粘液瘤早期增强和延迟表现为无强化,8例延迟增强表现为早期增强和延迟增强明显强化,4例表现为早期增强和延迟早期皆为轻度强化。血流动力学方面,2例心房起源的粘液瘤靠近房室瓣,随心动周期变化而进出心室。1例左房粘液瘤靠近右下肺静脉汇入左心房处,右下肺静脉可见轻度扩张。4例出现相应心房或心室扩大。结论心脏粘液瘤的MRI表现具有一定的特征性,MRI是诊断心脏粘液瘤的有效、重要检查方法。Objective To explore the MRI manifestations of cardiac myxoma. Methods 18 cases of myxoma which were confirmed through pathology were respectively analysed, and the patients were all examined by enhanced cardiac MRI before surgical resection. The sequences of eine, SE （ T1WI, T2 WI ） or IR （ Double IR, Tripple IR）, first pass and delayed gadolinium-enhanced were performed. The amount,location, size, margin, MRI signal manifestation, base, mobility, enhancement manifestation of myxomaTeardiac structure and haemodynamics were analysed. Results 14 cases of cardiac myxoma were in the left atrium. 10 cases originated from the artial septum. 6 cases were attached to the free wall of the atrium. 9 cases were pedunculated, and the other half exhibited a wide base. 10 cases demonstrated a round or roundlike shape and 8 cases demonstrated a lobulated shape. The signal intensity was low in eine which was lower than the heart muscle, high or moderately high in T2WI or Tripple IR , higher than the heart muscle. The signal of 3 cases were not homogeneous with mixed punctiform low signal intensity. Filling defects were shown in all cases. Early and late gadolinium enhancement was seen in 8 cases and no enhancement was displayed in 6 cases, and the other 4 cases were mildly enhanced. The haemodynamic changes were seen in 3 cases, in which two tumors were close to atrioventricular valve, the mass fluttered between atrium and ventricle during the heart cycle. The right inferior pulmonary vein was dilated mildly for the mass was close to the ostium of the right inferior pulmonary vein. Cardiac remodeling was seen in 4 cases, the atrium or ventricle was dilated. Conclusion The MRI manifestations of cardiac myxoma were characteristic to a certain extent, so cardiac MRI is an effective, important examination in the diagnosis of cardiac myxoma.

关 键 词：心脏肿瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R732.1[医药卫生—诊断学]