心脏原发良性肿瘤的临床分析及超声诊断价值

目的　评价黏液瘤以外的心脏原发良性肿瘤的临床特点、手术所见、病理学类型以及治疗情 况;评价超声心动图诊断黏液瘤以外的心脏原发良性肿瘤的准确性。方法　手术和病理证实为心脏良性 肿瘤患者26例。回顾性分析临床及术前超声心动图检查资料。结果　26例患者中,46.15%(12例)肿瘤 位于左心,38.46%(10例)位于右心,3.85%(1例)位于双心室,11.54%(3例)位于心包。26例中,脂肪瘤 6例(23.08%),淋巴管瘤5例(19.23%),纤维瘤4例(15.38%),横纹肌瘤4例(15.38%),平滑肌瘤2例 (7.69%),海绵状血管瘤2例(7.69%),嗜铬细胞瘤1例(3.85%),淋巴管囊肿1例(3.85%),心外膜囊肿 1例(3.85%)。4例横纹肌瘤均位于右心室,5例淋巴管瘤均位于左心室。横纹肌瘤与脂肪瘤、淋巴管瘤、 血管瘤及平滑肌瘤之间发病年龄差别具有显著性意义(P<0.01)。26例中,术前超声诊断心脏占位病变 性质待定22例(84.62%),诊断黏液瘤可能性大4例(15.38%)。结论　心脏良性肿瘤多位于左心,其次右 心,少数位于心包。不同类型心脏良性肿瘤可发生于不同年龄段。

Importance of clinic and echocardiography evaluating primary cardiac benign tumors

Objective To evaluate clinical manifestations, surgical findings, pathologic types and treatments of cardiac benign tumor except myxoma; To analyze their echocardiographic characteristics. Methods Records of 26 patients with cardiac tumors confirmed by operations and pathology were reviewed. Clinical and echocardiographic data of all patients were abstracted. Results The surgical findings revealed that 46.15%(12 cases) of benign tumors were on left heart, 38.46%(10 case) on right heart, 3.85%(1 cases) on two ventricles, 11.54%(3 cases) on pericardia. The pathology revealed that 26 cases were diagnosed as cardiac benign tumors including 6( 23.08%) lipomas, 5( 19.23%) lymphangiomas, 4( 15.38%) fibromas, 4( 15.38%) rhabdomyomas, 2( 7.69%) leiomyomas, 2( 7.69%) cavernous angioma, 1( 3.85%) chromaffinoma, 1( 3.85%) cystic lymphangioma, 1( 3.85%) cystis of pericardium. There were significant differences in the ages between rhabdomyomas and cardiac benign tumors of other types such as lipomas, lymphangiomas, angioma and leiomyomas(P< 0.01). In echocardiographic diagnoses,22 cases( 84.62%) were diagnosed only as space occupying lesions of the heart; 4 cases( 15.38%) suspected as myxoma. Conclusions Majority of benign tumors of the heart occurred on left side, following on right side, minority on pericardia. The different types of cardiac benign tumors occurred on different ages.