心脏肿瘤的超声影像与手术病理对照分析  

Comparative analysis between ultrasound image and the results of surgical pathological diagnosis of cardiac tumor

作　　者：牛永红 王廉一 唐秀杰 崔建 王春波 NIU Yong--hong;WANG Lian-yi;TANG Xiu-jie;CUI Jian;WANG Chun-bo(Center of Cardiology,First Affiliated Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院心脏中心,北京100016

出　　处：《中国临床医学影像杂志》2020年第3期184-187,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:通过对比心脏肿瘤的超声影像特征与手术病理及临床随访结果,总结心脏肿瘤的超声影像特征,提高超声.影像的诊断水平。方法:回顾性对比分析2003年1月一2019年10月我院经彩色多普勒超声心动图检查发现的疑似心脏肿瘤病变63例,对照分析声像图特征与手术病理结果。结果:63例病例中男27例(43%),女36例(57%),年龄4月~83岁,平均35.5岁,手术病理证实良性肿瘤49例,其中黏液瘤28例,其它类型良性心脏肿瘤21例,原发性恶性肿瘤11例,转移瘤2例,血栓1例。超声诊断良性黏液瘤28例,与手术病理结果符合率为100%;23例超声不能判断肿瘤病理类型(20例考虑良性,3例考虑恶性),手术病理结果证实21例为良性,1例为恶性,1例为血栓;12例超声诊断恶性肿瘤,与手术病理定性完全相符。结论:超声预测黏液瘤准确率高,心脏肿瘤如侵犯心脏系统,并伴有心包积液,更有可能为恶性。超声是诊断心脏肿瘤的主要检查手段,通过特殊的声像图特征,结合病史,可避免或减少误诊和漏诊的发生。Objective:Through comparing ultrasonic imaging characteristics and the results of surgical pathological diagno-sis and clinical follow-up of cardiac tumor,to summarize the ultrasonic imaging characterization and improve the identification of it.Method:Sixty-three cases of suspected cardiac tumor were found by color Doppler echocardiography examination in the First Affiliated Hospital of Tsinghua University from January 2003 to October 2019.The clinical features,echocardiograms characteristics,the results of surgical pathological diagnosis and elinical follow-up of these patients were compared and ana-lyzed retrospectively.Results:Among 63 patients,27(43%)were males,and 36(57%)were females.The age range was from 4 months to 83 years old.The average age was 35.5 years.All cardiac tumors obtain pathologic confirmation.There were 49 cases of benign tumors,including 28 patients with myxoma and 21 patients with other types.Eleven cases of malignant tu-mors and 2 cases of metastatic tumors,1 case of thrombus.Benign myxoma was diagnosed in 28 cases preoperatively by ul-trasound examination,which were consistent with surgical pathological results with accuracy of 100%.However there were 23 cases whose pathologic types could not be determined by ultrasound examination.Twenty cases were speculated as benign tu-mors and 3 cases were speculated as malignant tumor,but 21 cases were diagnosed as benign tumors,1 case was diagnosed as malignant tumor and 1 case was diagnosed as thrombus according postoperative pathological results.Twelve cases diagnosed as malignant by UCG,being consistent with postoperative pathological results.Conclusion:The accuracy of ultrasonography in predicting myxoma is high.Cardiac tumors that invaded the heart system and were associated with pericardial effusion were more likely to be malignant.Ultrasound was the main examination in the diagnosis of cardiac tumors,combined with the his-tory,by scanning the special features of the sonogram,misdiagnosis and missed diagnosis can be avoided or reduced.

关 键 词：心脏肿瘤 超声心动描记术 

分 类 号：R732.1[医药卫生—肿瘤] R540.45[医药卫生—临床医学]