摘要
目的探讨超声心动图对心脏继发性肿瘤的诊断价值。方法回顾性分析41例继发性心脏肿瘤超声心动图,探讨其来源构成、转移特点及声像图表现。结果41例中包括恶性肿瘤34例(肺癌22例、恶性淋巴瘤8例、乳腺癌3例、肝癌1例),良性肿瘤7例(静脉内平滑肌瘤)。原发肿瘤为肺癌、乳腺癌、肝癌患者共26例,其中24例(92.3%)于心腔内发现异常团块,16例(61.5%)可侵犯大血管(上腔静脉、下腔静脉、肺静脉)。原发肿瘤为恶性淋巴瘤8例,超声心动图均可见心室壁不规则低回声增厚区,其中3例于右心房、5例于心底大动脉旁发现团块状中低回声。原发肿瘤为恶性肿瘤34例中伴心包积液27例(79.4%)。静脉内平滑肌瘤7例于右心房发现不规则条索状结构,活动度大,追溯扫查,可见条索状肿物源自髂静脉-下腔静脉。化疗过程中随访复查,8例恶性淋巴瘤心脏转移瘤均有一定程度缩小,心包积液量亦有所减少,但均可见病情反复;26例化疗后未见明显变化。结论超声心动图对诊断心脏继发性肿瘤有重要价值,可判断病灶侵犯心脏及大血管的途径、范围,有利于临床准确判断病情、评估预后并采取相应的治疗手段。
Objective To investigate the value of echocardiography in diagnosis of patients with secondary cardiac tumors.Methods Echocardiography informations of 41 patients with secondary cardiac tumors were retrospectively analyzed to explore their origin,characteristics of metastasis and sonographic manifestations.Results Among the 41 patients,there were 34 patients with malignant tumors(22 cases of lung cancer,8 cases of malignant lymphoma,3 cases of breast cancer,1 cases of liver cancer)and 7 patients with benign tumors(venous leiomyoma).The primary tumors included lung cancer,breast cancer and liver cancer were found in 26 patients,among whom abnormal masses in the heart cavity was detected in 24 patients(92.3%),and invasion into large vessels(superior vena cava,inferior vena cava and pulmonary vein)was detected in 16 patients(61.5%).The primary tumor was malignant lymphoma in 8 patients,among whom irregular hypoechoic thickened areas of ventricular wall were found on echocardiography including the medium-low echo in the right atrium of 3 patients and next to the great artery in 5 patients.Among the 34 patients with primary malignant tumor,combined with pericardial effusion was found in 27 patients(79.4%).In 7 patients with venous leiomyoma,irregular cord-like structures with high activity were found in the right atrium,and the cord-like mass originated from iliac vein inferior-vena cava by retrospective scanning.During the follow-up and reexamination of chemotherapy,the cardiac metastases in 8 patients of malignant lymphoma were reduced to a certain extent,and the volumes of pericardial effusion were also reduced,but patients'conditions were repeated.There were no significant changes after chemotherapy in 26 patients.Conclusion Echocardiography is of value in diagnosis of patients with secondary cardiac tumors.It may be used to judge the way and scope of lesions invading the heart and great vessels,which is conducive to accurate judgement of patients'conditions,evaluation of prognoses and performance of corresponding treatments.
作者
王菲
曹士考
刘宏
彭龙
李玮
WANG Fei;CAO Shi-kao;LIU Hong;PENG Long;LI Wei(Department of Ultrasonic Diagnosis,the 980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Department of Clinical Laboratory,the 980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China)
出处
《临床误诊误治》
CAS
2022年第6期106-109,共4页
Clinical Misdiagnosis & Mistherapy
基金
河北省卫生厅指导性课题(20160258)。
关键词
心脏肿瘤
继发性
超声心动图
诊断价值
Heart neoplasms
Secondary
Echocardiography
Diagnostic value
