心脏超声造影鉴别右心占位病变的临床应用价值  

Clinical Value of Contrast Echocardiography in Distinguishing Right Heart System Space-occupying Lesions

作　　者：许崇俊 余承芳 沈红梅 鲁娜 成宪武 XU Chongjun;YU Chengfang;SHEN Hongmei;LU Na;CHENG Xianwu(Department of Ultrasound,Yanbian University Hospital,Yanji 133000,China;Department of Cardiology,Yanbian University Hospital,Yanji 133000,China)

机构地区：[1]延边大学附属医院超声科,延吉133000 [2]延边大学附属医院心内科,延吉133000

出　　处：《中国循环杂志》2024年第5期490-494,共5页Chinese Circulation Journal

基　　金：吉林省教育厅科学技术研究项目(JJKH20240697KJ);延边大学应用基础项目(ydkj202233)。

摘　　要：目的:探讨心脏超声造影鉴别右心占位病变的临床应用价值。方法:回顾性分析延边大学附属医院2019年1月至2023年1月期间39例经手术病理及临床治疗证实的右心占位病变患者的影像资料和临床资料。总结右心占位病变的心脏超声造影特征,并比较心脏超声造影与心脏磁共振成像(CMR)对右心占位病变的诊断效能。结果:39例患者的右心占位病变中,12例(30.8%)为血栓、赘生物,6例(15.4%)为良性肿瘤,21例(53.8%)为恶性肿瘤,其中血栓、赘生物、良性肿瘤、恶性肿瘤位于右心房的患者分别有8、4、4、17例。心脏超声造影诊断血栓、赘生物12例(30.8%),良性肿瘤5例(12.8%),恶性肿瘤22例(56.4%);CMR诊断血栓、赘生物18例(46.2%),良性肿瘤5例(12.8%),恶性肿瘤16例(41.0%)。心脏超声造影诊断与临床诊断的Kappa系数为0.956(P<0.001),CMR与临床诊断的Kappa系数为0.754(P<0.001)。结论:心脏超声造影可实时动态观察病变组织内血管化程度,能有效鉴别右心占位病变性质。Objectives:To investigate the clinical value of contrast echocardiography in the detection of right heart space-occupying lesions.Methods:The imaging and clinical data of 39 patients with right heart space-occupying lesions confirmed by surgery,pathology and clinical treatment in Yanbian University Hospital from January 2019 to January 2023 were retrospectively analyzed.All patients underwent contrast echocardiography and cardiac magnetic resonance(CMR)examinations.The contrast echocardiography features of right heart neoplastic from non-neoplastic occupying lesions were summarized.The diagnostic efficacy of contrast echocardiography and CMR in right heart space-occupying lesions was compared.Results:Among the 39 patients,12 patients(30.8%)were confirmed as thrombus and vegetation,6 patients(15.4%)as benign tumors and 21 patients(53.8%)as malignant tumors.There were 8,4,4 and 17 patients of thrombus,vegetation,benign tumor and malignant tumors located in right atrium,respectively.Contrast echocardiography was used to diagnose thrombus and vegetation in 12 patients(30.8%),benign tumors in 5 patients(12.8%),malignant tumors in 22 patients(56.4%).CMR was used to diagnose thrombus and vegetation in 18 patients(46.2%),benign tumors in 5 patients(12.8%),malignant tumors in 16 patients(41.0%).The Kappa coefficient between contrast echocardiography and clinical diagnosis was 0.956(P<0.001).The Kappa coefficient between CMR and clinical diagnosis was 0.754(P<0.001).Conclusions:Contrast echocardiography can dynamically observe the degree of vascularization in the lesion tissue in real-time,accurately distinguishing the nature of the right heart space-occupying lesions.

关 键 词：心脏超声造影 右心系统 占位病变 

分 类 号：R54[医药卫生—心血管疾病]