超声造影增强技术在心脏占位评估中的价值  

Evaluation of cardiac masses by contrast-enhanced ultrasound

作　　者：谷颖[1] 宋文娟 马雪娟[1] 刘利萍[1] 杨祥 赵月 孙钺[1] 王钰[1] 张浒[2] 李家宇[2] 陈伟[3] Gu Ying;Song Wenjuan;Ma Xuejuan;Liu Liping;Yang Xiang;Zhao Yue;Sun Yue;Wang Yu;Zhang Hu;Li Jiayu;Chen Wei(Department of Cardiology,the First Hospital of Kunming Medical University,Kunming 650032,China;Department of Cardiac Surgery,the First Hospital of Kunming Medical University,Kunming 650032,China;Department of Medical Imaging,the First Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院心内科,650032 [2]昆明医科大学第一附属医院心脏外科,650032 [3]昆明医科大学第一附属医院影像科,650032

出　　处：《中国心血管杂志》2020年第2期126-131,共6页Chinese Journal of Cardiovascular Medicine

基　　金：云南省卫生科技计划项目(2018NS0095)。

摘　　要：目的探讨超声造影增强技术(CEUS)对心脏占位的诊断及鉴别诊断价值。方法选取2016年9月至2019年5月在昆明医科大学第一附属医院行经胸超声心动图(TTE)诊断心脏占位的45例患者,进行心腔显影(CVO)及实时灌注显影(RTPI),并将CEUS结果与心脏磁共振、正电子放射断层造影术-计算机断层摄影术、术后病理、随访期间治疗效果进行对比,分析占位性质特征。结果心脏占位性质构成比分别为:血栓44.4%(20/45),肿瘤44.4%(20/45),其他11.1%(5/45)。CEUS诊断心腔内占位的准确性显著高于TTE,CEUS诊断不同占位的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为:(1)血栓:95.0%(19/20)、92.0%(23/25)、93.3%(42/45)、90.5%(19/21)和95.8%(23/24);(2)良性肿瘤:81.3%(13/16)、96.6%(28/29)、91.1%(41/45)、92.9%(13/14)和90.3%(28/31);(3)恶性肿瘤:75.0%(3/4)、97.6%(40/41)、95.6%(43/45)、75.0%(3/4)和97.6%(40/41)。结论CEUS可快速、安全、准确地判断心脏占位性质,对鉴别血栓和肿瘤具有较高的临床指导意义。Objective To explore the diagnostic and differential diagnostic value of contrast-enhanced ultrasound(CEUS)in cardiac mass.Methods A total of 45 patients diagnosed with cardiac mass by transthoracic echocardiography(TTE)in First Affiliated Hospital of Kunming Medical University from September 2016 to May 2019 were selected.Cardiac ventricular opacification(CVO)and real-time perfusion imaging(RTPI)were performed in all patients.At the same time,the results of CEUS were compared with those of cardiac magnetic resonance imaging and/or PET-CT and/or postoperative pathological diagnosis and/or follow-up therapy,including the nature of the mass.Results Among the cardiac masses of 45 patients,44.4%(20/45)of thrombus,44.4%(20/45)of tumor,and 11.1%(5/45)of others.The diagnostic accuracy by CEUS for cardiac mass was higher than that of TTE.The sensitivity and specificity,accuracy,positive predictive value,negative predictive value of CEUS for different cardiac mass were:(1)thrombus:95.0%(19/20),92.0%(23/25),93.3%(42/45),90.5%(19/21)and 95.8%(23/24);(2)benign tumor:81.3%(13/16),96.6%(28/29),91.1%(41/45),92.9%(13/14)and 90.3%(28/31);(3)malignant tumor:75.0%(3/4),97.6%(40/41),95.6%(43/45),75.0%(3/4)and 97.6%(40/41).Conclusions CEUS can quickly,safely and accurately determine the nature of cardiac mass,especially for the differential diagnosis of thrombus and tumor.

关 键 词：心脏占位 超声造影增强技术 实时灌注成像 

分 类 号：R73[医药卫生—肿瘤]