心脏脂肪瘤多模态影像学特征  

Multimodal Imaging Features of Cardiac Lipoma

作　　者：田萍 韩博 郑建民 李磊磊 郑敏文 刘莹 TIAN Ping;HAN Bo;ZHENG Jianmin;LI Leilei;ZHENG Minwen;LIU Ying(Department of Radiology,Xijing Hospital,Air Force Military Medical University,Xi’an 710032,China;不详)

机构地区：[1]空军军医大学西京医院放射科,陕西西安710032 [2]西安市中医医院放射科,陕西西安710032

出　　处：《中国医学影像学杂志》2024年第11期1129-1133,共5页Chinese Journal of Medical Imaging

摘　　要：目的 探讨多模态影像学在心脏脂肪瘤中的诊断价值。资料与方法 回顾性分析空军军医大学西京医院2016年7月—2022年11月确诊的14例心脏脂肪瘤患者的临床症状、超声心动图、CT及心脏磁共振特点。结果 5例脂肪瘤患者有胸闷、气促症状。14例心脏脂肪瘤共18处病灶;心脏脂肪瘤在心脏中分布广泛,其中9处位于心室腔内心内膜下(左心室腔6处,右心室腔3处),5处位于心肌内(左心室壁4处,右心室壁1处),3处位于心包内,1处位于右心房内。12例超声心动图表现为偏强回声肿块影,7例CT表现为均匀低密度肿块影。所有患者心脏磁共振表现为T1WI高信号,压脂序列肿块信号明显降低;T2WI为高信号,肿块周围可见低信号环,提示为化学位移伪影;心脏电影序列可见肿块柔软摆动,并随心动周期形态改变;首过灌注扫描未见灌注升高;延迟增强扫描未见强化。Native T1 mapping显示肿块T1值较正常心肌显著减低[(255.9±48.4)ms比(994.2±66.4)ms;t=-32.5,P<0.001]。结论 多模态影像学检查可为临床诊断心脏脂肪瘤提供客观依据。其中T1 mapping发现脂肪瘤T1值极低,对病灶观察更清楚,定位准确,对较小病变检查能力较强;因此,当怀疑心脏脂肪瘤时,T1 mapping可作为一种常规心脏肿块检查方法进行诊断及鉴别诊断。Purpose To investigate the diagnostic value of multimodal imaging in cardiac lipoma.Materials and Methods The clinical symptoms,echocardiography,CT and cardiac magnetic resonance images of 14 patients with cardiac lipoma diagnosed in Xijing Hospital of Air Force Military Medical University from July 2016 to November 2022 were retrospectively analyzed.Results Five patients with lipoma had symptoms of chest tightness and shortness of breath.A total of 18 lesions were found in 14 cases with cardiac lipoma.The locations of cardiac lipomas were widely distributed in the heart,of which 9 were located under the inner lining of the ventricular lumen(6 in the left ventricle,3 in the right ventricle),5 in the myocardium(4 in the left ventricle wall,1 in the right ventricle wall),3 in the pericardium,and 1 in the right ventricle.Echocardiography of 12 cases showed strong echoic mass image,and CT of 7 cases showed uniform low-density mass image.All patients cardiac magnetic resonance showed high signal of T1WI,and the tumor signal of lipid-pressure sequence decreased significantly.T2WI showed high signal and low signal ring around the tumor,indicating a chemical shift artifact.In the film sequence of heart,the mass could be seen to wobble gently and change in the shape of spontaneous motion cycle.The first perfusion scan did not show perfusion elevation.No enhancement was observed on the delayed enhanced scan.Native T1 mapping showed that the T1 value of mass was significantly lower than that of normal myocarda[(255.9±48.4)ms vs.(994.2±66.4)ms],and the difference was statistically significant(t=-32.5,P<0.001).Conclusion Multimodal imaging can provide objective evidence for clinical diagnosis of cardiac lipoma.Lipomas with extremely low T1 values were found,which is helpful to assist in the diagnosis of cardiac lipoma,clearer observation of the lesions,accurate localization,and strong ability to detect small lesions.Therefore,when cardiac lipoma is suspected,T1 mapping can be used as a routine examination method for the dia

关 键 词：心脏肿瘤 脂肪瘤 磁共振成像 体层摄影术 X线计算机 超声心动描记术 

分 类 号：R732.1[医药卫生—肿瘤] R445[医药卫生—临床医学]