| 摘要: |
| 目的评判心脏占位性病变的超声诊断价值。方法35例心脏占位性病变应用二维及彩色多普勒超声多切面观察其大小、形态、位置、活动度及心脏血流动力学变化,结合临床病史、其他影像手段及病理,回顾性分析超声误诊及漏诊原因。结果所观察病例以心脏肿瘤最多见,良性肿瘤10例,原发性恶性肿瘤3例,转移瘤3例。其中1例良性乳头状弹力纤维瘤超声诊断为赘生物。1例恶性原发性心脏横纹肌肉瘤超声诊断为黏液瘤。2例肿瘤为多部位多发,超声发生漏诊。其次为血栓8例,赘生物6例,癌栓5例。其中1例血栓超声诊断为肿瘤,2例怀疑心尖部血栓,后证实为超声伪像。超声诊断敏感性为95%。超声诊断特异性为86%。结论超声是心脏占位性病变检出首选的重要检查手段,漏诊多见于多发肿瘤及多发赘生物,多切面仔细扫查可减少其发生。误诊主要发生于恶性肿瘤超声诊断为良性肿瘤,血栓超声诊断为肿瘤,良性肿瘤诊断为赘生物等,在结合病史及其他影像方法的基础之上,把握占位性病变特殊的超声声像学征象,以提高超声诊断占位性病变组织特征的辨识力,尤其在原发性心脏肿瘤组织特性的辨别上减少误诊的发生。 |
| 关键词: 超声心动图 占位性病变 血栓 赘生物 心脏肿瘤 |
| DOI：10.3969/j.issn1008-0392.2013.03.015 |
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| 基金项目:上海市浦东新区心血管疾病学科群(PWZxkq2010-01) |
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| Echocardiography in diagnosis of cardiac occupying lesions |
| MA Jing,CHEN Ming |
| (1.Dept.of Cardiovascular Medicine,East Hospital,Tongji University,Shanghai 200120,China) |
| Abstract: |
| Objective To evaluate the application of echocardiography in diagnosis of cardiac occupying lesions.Methods Thirty five patients with cardiac occupying lesions underwent echocardiographic examination.The size,appearance,location,mobility,hemodynamics of cardiac lesions were assessed by ultrasonography.The reasons for misdiagnosis or missed diagnosis were analyzed retrospectively,based on history,test results and pathology.Results Among all lesions cardiac tumors（17 cases） were most common,including 10 cases of benign tumors,3 cases of malignant tumors and 3 cases of metastatic tumors.A case of corpora mammillaria elastofibroma was misdiagnosed as ecphyma;a case of cardiac primarily rhabdosarcoma was misdiagnosed as myxoma;sites and numbers of tumors were missed for diagnosis in 2 cases of multiple tumors.In the remaining cases 8 were thrombus,6 were ecptomas and 5 were tumor embolus.A case of thrombus was misdiagnosed as tumor,two cases of ultrasonic pseudoorphisms were diagnosed as thrombus.The overall sensitivity of echocardiography was 95% and the specificity 86%.Conclusion Ultrasonography is primary examination for diagnosis of cardiac occupying lesions;the misdiagnosis and missed diagnosis can be avoided or reduced through scanning some special sonographic features and combining with history and other imaging methods. |
| Key words: echocardiogram occupying lesion thrombus vegetation cardiac tumor |
