超声造影诊断右心房憩室伴血栓形成1例  

Contrast-enhanced ultrasound for the diagnosis of right atrial diverticulum with thrombus:a case report

作　　者：周虹[1] 王晓旭 马若煊 郭子杰 尹洪宁[1] Zhou Hong;Wang Xiaoxu;Ma Ruoxuan;Guo Zijie;Yin Hongning(Department of Cardiac Ultrasound,Luquan Campus,the Second Hospital of Hebei Medical University,Shijiazhuang 050227,China)

机构地区：[1]河北医科大学第二医院鹿泉院区心脏超声科,石家庄050227

出　　处：《中华超声影像学杂志》2025年第1期49-51,共3页Chinese Journal of Ultrasonography

摘　　要：右心房憩室是一种罕见的先天性心脏畸形,发病率极低,相关文献报道较少。该病表现为起源于右心房游离壁或右心耳的囊状结构,憩室壁多由正常的心肌组织组成,患者早期多无症状,多于影像学检查时发现。患者男,96岁,主因间断胸闷、气短伴头晕半月余就诊于河北医科大学第二医院,患者入院1 d后行超声心动图及心脏超声造影检查,提示右心房憩室伴血栓形成,入院4 d后行心脏CT血管造影检查,考虑右心房憩室,其内充盈缺损,可疑血栓形成。患者年龄较大,未接受进一步诊治,1个月后复查心脏超声,右房憩室内团块大小和形态无明显变化。笔者通过对1例最初被误诊为心包积液的右心房憩室患者进行详细分析,并探讨心脏声学造影技术在心脏超声诊断中的关键作用,旨在提高心脏超声医师对右心房憩室的诊断意识。Right atrial diverticulum is a rare congenital cardiac malformation with a very low incidence and few reports in the literature.It is a sac-like structure originating from the free wall of the right atrium or the right auricle,and the wall of the diverticulum is mostly composed of normal myocardial tissue.Patients with diverticulumare asymptomatic in the early stage of the disease,and it is mostly detected by imaging examinations.The patient was a 96-year-old male admitted to the Second Hospital of Hebei Medical University with intermittent chest tightness,shortness of breath,and dizziness for more than half a month.Echocardiography and contrast echocardiography were performed 1 d after the patient was admitted to the hospital,suggesting the diagnasis of right atrial diverticulum with thrombosis,and coronary CT angiography was performed 4 d after the patient was admitted to the hospital,which considered right atrial diverticulum,with an internal filling defect,and suspected thrombus formation.The patient was older and did not receive further diagnosis and treatment,and cardiac ultrasound was repeated 1 month later,with no significant change in the size and morphology of the mass within the right atrial diverticulum.By analyzing in detail a case with right atrial diverticulum initially misdiagnosed as pericardial effusion,this article aimed to raise cardiac sonographers'awareness of the diagnosis of right atrial diverticulum and to explore the key role of cardiac acoustic contrast technology in cardiac ultrasound diagnosis.

关 键 词：超声心动描记术 右心房憩室 血栓 

分 类 号：R540.45[医药卫生—心血管疾病] R541.1[医药卫生—内科学]