心脏弹力纤维瘤的超声心动图特征及鉴别诊断  

作　　者：王丹[1,2] 郑哲岚 方爱娟[4] 

机构地区：[1]浙江中医药大学研究生院,310053 [2]杭州市临安区第一人民医院,311300 [3]浙江大学医学院附属第一医院,310003 [4]南京大学医学院附属鼓楼医院,210008

出　　处：《浙江临床医学》2023年第12期1856-1858,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨心脏乳头状弹力纤维瘤(CPF)的超声心动图特征、鉴别诊断要点及临床表现,以提高超声医师对CPF的认识。方法回顾总结自2018年1月至2022年12月在浙江大学医学院附属第一医院手术后经病理证实的15例CPF患者的临床相关资料、超声心动图特征及术后随访情况。结果15例患者均无特异性临床表现,术前经胸超声心动图及术中经食管超声心动图均发现心脏内占位团块,其中1例为多发(6.67%),分别位于主动脉瓣及右心房内,余肿瘤均为单发(93.33%),其中位于瓣膜10例(71.42%),依次为主动脉瓣5例、二尖瓣4例、肺动脉瓣1例;位于心腔4例(28.58%),依次左心室3例、右心室1例,其中最大者长径19 mm,最小者长径5 mm。15例患者均行心脏肿瘤手术切除,手术过程顺利,术后病理证实均为CPF。结论CPF多数患者无典型临床症状,经胸超声心动图是首选检查,必要时可进行经食道超声心动图,最常见的部位为心脏瓣膜,尤其是主动脉瓣,多呈圆形或卵圆形,内部多数呈高回声,边界清晰,半数有蒂,有一定活动度;肿瘤内部彩色多普勒未能显示血流信号。手术切除是治疗首选方法,预后良好。Objective To investigate the echocardiographic features,differential diagnosis and clinical manifestations of cardiac papillary elastofibroma,in order to improve the understanding of cardiac papillary elastofibroma.Methods The clinical data,echocardiographic features and postoperative follow-up of 15 patients with CPF confirmed by pathology after surgery in the First Hospital of Zhejiang Province from January 2018 to December 2022 were retrospectively summarized.Results All the 15 patients had no specific clinical manifestations.Preoperative transthoracic echocardiography and intraoperative transesophageal echocardiography showed mass in the heart,of which 1 case was multiple(6.67%),located in the aortic valve and right atrium,respectively.The remaining tumors were single(93.33%),of which 10 cases were located in the valve(71.42%),followed by 5 cases of aortic valve,4 cases of mitral valve and 1 case of pulmonary valve.There were 4 cases(28.58%)located in the heart chamber,3 cases in the left ventricle and 1 case in the right ventricle.The longest diameter was 19 mm and the smallest was 5 mm.All 15 patients underwent surgical resection of cardiac tumors,and the operation was successful.Postoperative pathology confirmed CPF.Conclusion Most patients with CPF have no typical clinical symptoms.Transthoracic echocardiography is the first choice,and transesophageal echocardiography can be performed if necessary.The most common site is cardiac valve,especially aortic valve,which mostly shows round or oval,and most of the interior is highly echoic,which the border is clear,and half have a peduncle,and there is a certain degree of activity.Color Doppler inside the tumor show no blood flow signals.Surgical resection is the preferred treatment,and the prognosis is good.

关 键 词：乳头状弹力纤维瘤 心脏肿瘤 超声心动图 经食道超声心动图 

分 类 号：R540.45[医药卫生—心血管疾病] R732.1[医药卫生—内科学]