金岩,王辉山,邓东安,侯传举,于岩.术前超声心动图评价原发性心脏黏液瘤及肺动脉压的诊断价值[J].中国医学影像技术,2010,26(10):1889~1891
术前超声心动图评价原发性心脏黏液瘤及肺动脉压的诊断价值
Preoperative echocardiographic evaluation on cardiac myxomas and the pressure of pulmonary artery
投稿时间:2010-04-20  修订日期:2010-08-11
DOI:
中文关键词:  心脏黏液瘤  高血压,肺性  超声心动描记术
英文关键词:Cardiac myxomas  Hypertension, pulmonary  Echocardiography
基金项目:
作者单位E-mail
金岩 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110840  
王辉山 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110840 huishanwang@hotmail.com 
邓东安 中国人民解放军沈阳军区总医院先心病内科,辽宁 沈阳 110840  
侯传举 中国人民解放军沈阳军区总医院先心病内科,辽宁 沈阳 110840  
于岩 中国人民解放军沈阳军区总医院心外科,辽宁 沈阳 110840  
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中文摘要:
       目的 探讨术前超声心动图综合评价黏液瘤的形态、大小、发生部位以及肺动脉压的价值。方法 采集132例(男47例,女85例)心脏黏液瘤患者的术前超声评价、临床症状、术中所见及预后等临床资料,进行回顾性分析。结果 ①临床症状:心慌、气短84例(63.64%),栓塞12例(9.09%),晕厥11例(8.33%),发热5例(3.79%),贫血2例(1.52%),胸腔积液2例(1.52%),心房颤动9例(6.82%),肾炎3例(2.27%)。②术中所见:左心房黏液瘤121例(91.67%),右心房黏液瘤11例(8.33%)。起源于房间隔左心房面81例(61.36%),左心房后壁19例(14.39%),左心房顶部16例(12.12%),靠近二尖瓣环5例(3.79%);起源于房间隔右心房面5例(3.79%),下腔静脉开口附近5例(3.79%),冠状静脉窦内1例(0.76%)。本组中2例复发。③根据是否有肺动脉压力增高将121例左心房黏液瘤患者分为两组,两组间瘤体大小差异有统计学意义 (P<0.05);起源于左心房顶部者瘤蒂明显长(P<0.05),伴有肺动脉压力增高的例数所占比重明显低于其他黏液瘤(P<0.05),该黏液瘤质量也明显大于其他黏液瘤(P<0.01)。结论 黏液瘤形态、大小、发生部位与肺动脉压有一定关系,超声心动图应作为术前诊断的重要手段。
英文摘要:
      Objective evaluate cardiac myxomas on the original position, clinical symptoms, prognosis and the relation to the pressure of pulmonary artery with echocardiography preoperatively. Methods The pre-operative echocardiogram, clinlcal symptoms and findings in operation of 132 patients (47 male and 85 female) with cardiac myxomas were analyzed retrospectively. Results ①Clinical symptoms: Dyspnea happened in 84 patients (63.64%), embolism in 12 (9.09%), apopsychia in 11 (8.33%), fever in 5 (3.79%), hemophthisis in 2 (1.52%), pleural effusion in 2 (1.52%), atrial fibrillation in 9 (6.82%)and nephritis in 3 (2.27%). ②Anatomical findings: Left atrial myxomas were found in 121 patients (91.67%), while right atrial myxomas in 11 patients (8.33%). Among left atrial myxomas, 81 generated in atrial septum (61.36%), 19 in the posterior wall of left atrium (14.39%), 16 in the top of left atrium (12.12%), 5 nearby mitral annulus (3.79%). Among right atrial myxomas, 5 generated in atrial septum (3.79%), 5 nearby inferior vena cave (3.79%), 1 in vena coronaria sinus (0.76%). The tumors recurred after treatment in 2 patients. ③One hundred and twenty-one patients of left atrial myxomas were divided into two groups according to pulmonary arterial pressure. The sizes of myxomas body were significant difference in two groups (P<0.05). The myxomas in the top of left atrium caused less pulmonary hypertension (P<0.05), had longer pedicel (P<0.05) and more weight (P<0.01). Conclusion Pulmonary artery pressure has some relationship with the shape, size and position of the cardiac myxomas. Echocardiography should be considered as an important method of preoperative evaluation of cardiac myxomas.
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