心脏肿瘤的超声影像与手术病理对照分析

牛永红,王廉一,唐秀杰,崔 建,王春波

中国临床医学影像杂志 ›› 2020, Vol. 31 ›› Issue (3) : 184-187.

中国临床医学影像杂志 ›› 2020, Vol. 31 ›› Issue (3) : 184-187. DOI: 10.12117/jccmi.2020.03.009
心脏、血管影像学

心脏肿瘤的超声影像与手术病理对照分析

  • 牛永红,王廉一,唐秀杰,崔 建,王春波
作者信息 +

Comparative analysis between ultrasound image and the results of surgical pathological diagnosis of cardiac tumor

  • NIU Yong-hong, WANG Lian-yi, TANG Xiu-jie, CUI Jian, WANG Chun-bo
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文章历史 +

摘要

目的:通过对比心脏肿瘤的超声影像特征与手术病理及临床随访结果,总结心脏肿瘤的超声影像特征,提高超声影像的诊断水平。方法:回顾性对比分析2003年1月—2019年10月我院经彩色多普勒超声心动图检查发现的疑似心脏肿瘤病变63例,对照分析声像图特征与手术病理结果。结果:63例病例中男27例(43%),女36例(57%),年龄4月~83岁,平均35.5岁,手术病理证实良性肿瘤49例,其中黏液瘤28例,其它类型良性心脏肿瘤21例,原发性恶性肿瘤11例,转移瘤2例,血栓1例。超声诊断良性黏液瘤28例,与手术病理结果符合率为100%;23例超声不能判断肿瘤病理类型(20例考虑良性,3例考虑恶性),手术病理结果证实21例为良性,1例为恶性,1例为血栓;12例超声诊断恶性肿瘤,与手术病理定性完全相符。结论:超声预测黏液瘤准确率高,心脏肿瘤如侵犯心脏系统,并伴有心包积液,更有可能为恶性。超声是诊断心脏肿瘤的主要检查手段,通过特殊的声像图特征,结合病史,可避免或减少误诊和漏诊的发生。

Abstract

Objective: Through comparing ultrasonic imaging characteristics and the results of surgical pathological diagnosis and clinical follow-up of cardiac tumor, to summarize the ultrasonic imaging characterization and improve the identification of it. Method: Sixty-three cases of suspected cardiac tumor were found by color Doppler echocardiography examination in the First Affiliated Hospital of Tsinghua University from January 2003 to October 2019. The clinical features, echocardiograms characteristics, the results of surgical pathological diagnosis and clinical follow-up of these patients were compared and analyzed retrospectively. Results: Among 63 patients, 27(43%) were males, and 36(57%) were females. The age range was from 4 months to 83 years old. The average age was 35.5 years. All cardiac tumors obtain pathologic confirmation. There were 49 cases of benign tumors, including 28 patients with myxoma and 21 patients with other types. Eleven cases of malignant tumors and 2 cases of metastatic tumors, 1 case of thrombus. Benign myxoma was diagnosed in 28 cases preoperatively by ultrasound examination, which were consistent with surgical pathological results with accuracy of 100%. However there were 23 cases whose pathologic types could not be determined by ultrasound examination. Twenty cases were speculated as benign tumors and 3 cases were speculated as malignant tumor, but 21 cases were diagnosed as benign tumors, 1 case was diagnosed as malignant tumor and 1 case was diagnosed as thrombus according postoperative pathological results. Twelve cases diagnosed as malignant by UCG, being consistent with postoperative pathological results. Conclusion: The accuracy of ultrasonography in predicting myxoma is high. Cardiac tumors that invaded the heart system and were associated with pericardial effusion were more likely to be malignant. Ultrasound was the main examination in the diagnosis of cardiac tumors, combined with the history, by scanning the special features of the sonogram, misdiagnosis and missed diagnosis can be avoided or reduced.

关键词

心脏肿瘤 / 超声心动描记术

Key words

Heart neoplasms / Echocardiography

引用本文

导出引用
牛永红,王廉一,唐秀杰,崔 建,王春波. 心脏肿瘤的超声影像与手术病理对照分析[J]. 中国临床医学影像杂志. 2020, 31(3): 184-187 https://doi.org/10.12117/jccmi.2020.03.009
NIU Yong-hong, WANG Lian-yi, TANG Xiu-jie, CUI Jian, WANG Chun-bo. Comparative analysis between ultrasound image and the results of surgical pathological diagnosis of cardiac tumor[J]. Journal of China Clinic Medical Imaging. 2020, 31(3): 184-187 https://doi.org/10.12117/jccmi.2020.03.009
中图分类号: R732.1    R540.45   

参考文献

[1]Strecker T, Rosch J, Weyand M, et al. Primary and metastatic cardiac tumors: imaging characteristics, surgical treatment, and histopathological spectrum: a 10-year-experience at a German heart center[J]. Cardiovasc Pathol, 2012, 21(5): 436-443. [2]Nomoto N, Tani T, Konda T, et al. Primary and metastatic cardiac tumors: echocardiographic diagnosis, treatment and prognosis in a 15-years single center study[J]. J Cardiothorac Surg, 2017, 12(1): 103. [3]Shuai H, Cao Y, Wei Q, et al. Prevalence of primary cardiac tumor malignancies in retrospective studies over six decades: a systematic review and meta-analysis[J]. Oncotarget, 2017, 8(26): 43284-43294. [4]王翠华,黄云洲,任书堂,等. 实时三维超声心动图在心脏占位性病变中的应用价值[J]. 中国临床医学影像杂志,2006,17(9):505-507. [5]Tumma R, Dong W, Wang J, et al. Evaluation of cardiac masses by CMR-strengths and pitfalls: A tertiary center experience[J]. Int J Cardiovasc Imaging, 2016, 32(6): 913-920. [6]Baikoussis NG, Papakonstantinou NA, Dedeilias P, et al. Cardiac tumors: a retrospective multicenter institutional study[J]. J BUON, 2015, 20(4): 1115-1123. [7]Dinesh Kumar US, Murugesh W, Prasad SS, et al. Left atrial myxoma—A tumor in transit[J]. Ann Card Anaesth, 2019, 22(4): 432-434. [8]Bayramoglu Z, Oral K, Ezelsoy M, et al. Second recurrence of familial atrial myxomas: mother and daughter simultaneously[J]. Cardiovasc J Afr, 2019, 30(3): e3-e6. [9]Zanobini M, Russo AD, Saccocci M, et al. Endomyocardial biopsy guided by intracardiac echocardiography as a key step in intracardiac mass diagnosis[J]. BMC Cardiovasc Disord, 2018, 18(1): 15. [10]Maleszewski JJ, Anavekar NS, Moynihan TJ, et al. Pathology, imaging, and treatment of cardiac tumours[J]. Nat Rev Cardiol, 2017, 14(9): 530-549. [11]Travis WD, Brambilla E, Burke AP, et al. WHO classification of tumors of the lung, pleura, thymus and heart[M]. Lyon: IARC Press, 2015. [12]张晓雅,吴清玉,靳永强,等. 二尖瓣血性囊肿的诊断及手术治疗[J]. 心肺血管病杂志,2019,38(10):1028-1031. [13]余刚,崇蕾,苏苗赏,等. 儿童肺炎支原体肺炎50例临床特征与高凝状态研究[J]. 医学研究杂志,2019,48(2):114-116.

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