右心房肿瘤的超声心动图影像学特征及病理结果分析  

Analysis of Clinical and Ultrasonographic Features of Right Atrium Occupying Lesion

作　　者：马慧 杨自豪 牛义翠 郑敏娟 Ma Hui;Yang Zihao;Niu Yicui;Zheng Minjuan(Department of Ultrasound,the First Affiliated Xijing Hospital,Air Force Medical University,Xi’an,Shanxi 710032,China)

机构地区：[1]空军军医大学第一附属医院超声医学科,西安市710032

出　　处：《中国超声医学杂志》2021年第7期771-775,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析右心房肿瘤的超声影像特征及病理结果,为提高心脏肿瘤诊断水平提供依据。方法连续收集94例超声诊断为右心房肿瘤患者的超声心动图及病理资料,分析总结右心房肿瘤的常见类型及影像特征。结果 94例超声诊断为右心房肿瘤的患者58.5%有心电图异常,以T波及ST段改变为主(67.3%)。其继发改变以右心扩大为主(右房扩大46.8%,右室扩大24.5%),部分患者伴有三尖瓣梗阻(21.3%)和心包积液(13.8%,多为恶性肿瘤),极少数患者伴有肺高压(2.1%)。与病理结果对照,超声诊断符合率为94.7%(89/94),误诊为肿瘤的常见类型为血栓及血囊肿。病理确诊的89例右心房肿瘤中良性肿瘤偏多(55.1%),转移肿瘤居多(52.8%):原发于肝脏的恶性转移瘤居首位(25.8%),良性静脉平滑肌瘤为右心房第二常见转移瘤类型(13.5%);原发性良性肿瘤按发病率依次为黏液瘤、脂肪瘤、纤维组织瘤样增生(30.3%,4.5%,3.4%)。结论右心房肿瘤以良性居多,转移肿瘤比原发肿瘤多见(良性静脉平滑肌瘤亦常发生右心转移)。超声心动图可协助判断肿瘤的良恶性、评估原发灶,为术前的诊疗决策提供重要依据。Objective Right atrium(RA) was a common site of primary and secondary cardiac tumors. This study mainly analyzed the echocardiographic features and pathologic results of right atrium tumors to provide a basis for improving the diagnosis of cardiac tumors. Methods Echocardiographic and pathologic findings of 94 patients with right atrial tumors diagnosed by echocardiography in our hospital were collected continuously. A retrospective analysis was conducted to summarize the common types and imaging characteristics of right atrium occupying lesions compared with pathology results. Results The rate of electrocardiogram abnormality of these 94 patients with right atrial tumors diagnosed by echocardiography was 58.5% and 67.3% were T-wave and ST-segment changes. The mainly secondary changes were enlargement of RA(46.8%) and right ventricular( RV, 24.5%), tricuspid valve obstruction(21.3%), pericardial effusion(13.8%, mostly malignant), only a very small numbers of patients with pulmonary hypertension(2.1%). Compared with the pathological results, the coincidence rate of echocardiographic diagnosis was 94.7%(89/94) and the common misdiagnosis of RA tumors was thrombosis and blood cyst. In this 89 right atrium tumors confirmed by Pathology, benign tumors(55.1%) were more common than malignant, metastatic tumors(52.8%) were more common than primary tumors and metastatic tumors originating from the liver(25.8%) were the most common malignancies. Benign leiomyoma extension of RA was the second most common type of metastatic tumors(13.5%). The most common primary benign tumors was myxoma(30.3%), followed by lipoma(4.5%) and fibrous hyperplasia(3.4%). Conclusions Benign tumors were more common in right atrium tumors, and metastatic tumors were more common than primary tumors. Metastatic tumors were more common than primary tumors. Echocardiography helps distinguish benign and malignant tumors and evaluate the origin site, providing an important basis for preoperative diagnosis and treatment decision.

关 键 词：超声心动图 右心房 占位性病变 心脏肿瘤 

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