心脏血管瘤1例并文献复习  

Cardiac hemangioma:a case report and literature review

作　　者：范丽娟[1] 张计旺[1] 祁汉雄 FAN Lijuan;ZHANG Jiwang;QI Hanxiong(Department of Radiology,TEDA International Cardiovascular Hospital,Tianjin 300457,China)

机构地区：[1]泰达国际心血管病医院放射科,天津300457

出　　处：《国际医学放射学杂志》2021年第2期217-221,共5页International Journal of Medical Radiology

摘　　要：目的探讨心脏血管瘤的临床表现、影像特征和病理特点,以提高对心脏血管瘤的认识和鉴别诊断能力。方法回顾性分析1例经手术病理证实的心脏血管瘤病人的影像及病理资料并行文献复习。结果超声心动图上可见胸腔内主动脉根部右后方、腹主动脉膈肌水平左前方一实性为主的中等回声团,内部可见低、无回声区,周边可见强回声的钙化,血流未见异常。CT显示心脏肿物位于左室下壁,密度欠均匀,内部及边缘可见明显钙化;增强后病变轻度强化。MRI显示左室下壁基底段肿物明显向腔外突出,信号不均匀,增强后呈不均匀轻度强化。选择性冠状动脉造影可见肿瘤供血动脉来源于右冠状动脉。PET/CT显示病灶呈糖代谢缺失。正电子发射计算机断层扫描(PET/CT)显示病灶呈糖代谢缺失。结论心脏血管瘤可发生于心脏肌层,如发现心脏肌层肿物存在冠状动脉供血及明显蛋壳样钙化时,即使不具有典型强化表现,也需考虑血管瘤的诊断。Objective To explore the clinical manifestations,imaging characteristics and the pathological features of cardiac hemangioma in order to improve the recognition and the ability of making different diagnosis.Methods A case of cardiac hemangioma confirmed by pathology was analyzed retrospectively on the basis of literatures review.Results Echocardiography showed that a solid medium echo mass was seen at the right rear of the aortic root in the chest and in the left front of the diaphragm level of the abdominal aorta,low and anechoic areas were seen inside,strong echo calcification could be seen around,and no abnormal blood flow was found.CT showed that the cardiac mass was located in the inferior wall of the left ventricle,with inhomogeneous density,obvious calcification in the interior and edge,and slight enhancement after enhancement.MRI showed that the tumor in the basal segment of the inferior wall of the left ventricle was obviously protruding out of the cavity,the signal was uneven,and showed inhomogeneous and mild enhancement after enhancement.Tumor blood supply arteries originated from the right coronary artery by observing the selective coronary angiography.Positron emission tomography/computed tomography(PET/CT)showed deficiency of glucose metabolism.Conclusion Cardiac hemangioma can occur in cardiac myocardium.If the tumor are supplied by coronary artery and eggshell calcification are found in the tumor,the diagnosis of hemangioma should be considered even without typical enhancement.

关 键 词：心脏肿瘤 血管瘤 体层摄影术 X线计算机 磁共振成像 超声心动图 

分 类 号：R732.1[医药卫生—肿瘤] R445[医药卫生—临床医学]