声诺维超声造影在心脏占位性病变中的应用价值  

Application Value of Contrast-enhanced Ultrasound in Cardiac Space Occupying Lesions

作　　者：李威 景红霞 郑霜 肖飞 李甜甜 郑光美 胡培 肖彬 许涛 LI Wei;JING Hong-xia;ZHENG Shuang;XIAO Fei;LI Tian-tian;ZHENG Guang-mei;HU Pei;XIAO Bin;XU Tao(Department of Ultrasound,2Department of Oncology,Renmin Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属人民医院超声科,湖北十堰442000 [2]湖北医药学院附属人民医院肿瘤科,湖北十堰442000

出　　处：《湖北医药学院学报》2023年第4期406-410,414,共6页Journal of Hubei University of Medicine

基　　金：湖北省卫生健康科研基金资助项目(WJ2021F041);湖北省十堰市引导性科研项目(22Y53)。

摘　　要：目的:讨论声诺维超声造影(CEUS)在心脏占位性病变诊断中的价值。方法:选择2021年1月~2022年10月因心脏占位性病变于我院接受治疗的26例患者为研究对象,所有患者均行常规经胸超声心动图(TTE)检查及CEUS检查。分析TTE、CEUS结果,实性占位分析CEUS时间-强度曲线结果。结果:实性占位21例,其中血栓9例,TTE多表现为肿物内部呈低回声,基底部较宽,活动性小或无,CEUS多表现为病灶内部无增强;粘液瘤6例,TTE多表现为肿物内部呈低或稍高回声,有蒂与房壁相连接,活动度大,CEUS多表现为病灶内部稀疏增强,较周围心肌组织低;恶性肿瘤6例,TTE多表现为肿物内部呈均匀或不均匀低回声,基底部宽,边界不清,活动性小或无,CEUS多表现为病灶内部呈明显增强,且较周围心肌组织高。囊性占位5例,冠状动脉瘤1例,CEUS表现为造影剂通过主动脉窦部后即刻囊腔内见造影剂进入,随心动周期呈喷射样;左房壁间血肿1例,CEUS表现为病变内部及分隔均无增强;心室壁夹层瘤3例,与心腔不通者1例,CEUS表现为病变内部无造影剂进入,与心腔相通者2例,CEUS表现为造影剂于收缩期从左室进入囊腔内。21例实性占位中,1例血栓和4例粘液瘤病变部位的时间-强度曲线结果均较心肌组织低平,并且峰值强度较周围心肌组织低;1例粘液瘤和6例恶性肿瘤病变部位的时间-强度曲线结果较心肌组织陡峭,且其峰值强度高于周围心肌组织;其余8例血栓及1例粘液瘤CEUS无增强,也无时间-强度曲线。结论:CEUS能较好地对心脏占位性病变做出定性诊断,对患者临床诊断治疗和预后具有一定的指导意义,值得在临床诊疗中推广应用。Objective The aim of this study was to explore the diagnostic value of contrast-enhanced ultrasound(CEUS)in cardiac space occupying lesions.Methods From January 2021 to October 2022,26 patients who were treated in our hospital due to cardiac space-occupying lesions were selected as the research subjects.All patients underwent routine transthoracic echocardiography(TTE)examination and CEUS examination.The results of TTE,CEUS and solid lesions analyzed by time-intensity curve were analyzed.Results There were 21 cases of solid space occupying lesions,including 9 cases of thrombosis.TTE mostly showed low echo inside the tumor,wide base and little or no activity.CEUS mostly showed no enhancement inside the lesion.In 6 cases of myxoma,TTE mostly showed low or slightly high echo inside the tumor,with pedicle connected to the atrial walland high activity;CEUS mostly showed sparse enhancement inside the lesion,lower than the surrounding myocardial tissue;6 cases of malignant tumors,TTE mostly showed homogeneous or uneven low echo inside the tumor,wide base,unclear boundary,small or no activity,CEUS mostly showed obvious enhancement inside the tumor,higher than the surrounding myocardial tissue.There were 5 cases of cystic space-occupying and 1 case of coronary aneurysm.CEUS showed that the contrast agent entered the cyst cavity immediately after passing through the aortic sinus,and it was ejected with the cardiac cycle.There was 1 case of left atrial intramural hematoma showing no enhancement in the lesion and septum.there were 3 cases of ventricular wall dissection tumors,in which 1 case was blocked from the heart chamber.CEUS showed that there was no contrast medium entering the lesion,and 2 cases were connected with the heart chamber.CEUS showed that the contrast agent was in the systole entering the cyst cavity from the left ventricle.Among the 21 cases of solid mass,the time-intensity curve results of 1 case of thrombus and 4 cases of myxoma lesions were lower than those of myocardial tissue,and the peak intensity wa

关 键 词：心脏占位性病变 超声造影 肿瘤 

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