心脏黏液瘤MRI与手术病理对照研究

目的 通过MRI与病理对照研究探讨MRI诊断心脏黏液瘤的价值.方法 22例心脏黏液瘤均经MR检查,分析其MRI表现,并与手术病理对照.结果 22例中21例单发,其中左房12例,右房6例,左室2例,右室1例.1例多发.MRI表现:22例中19例信号欠均匀,3例信号均匀.心脏电影:18例带蒂,4例基底较宽.13例引起瓣膜狭窄或关闭不全.9例出现心功能异常.增强扫描,19例轻至中度不均匀强化,其中4例行首过灌注,时间-信号强度曲线呈锯齿状缓慢上升,延迟扫描瘤蒂及瘤壁明显强化.3例未见强化.手术:21例呈卵圆形略分叶状,1例呈葡萄串状.10例可见新鲜出血,5例见陈旧出血,14例出现坏死,2例出现囊变,4例见钙盐沉积.病理:19例见小血管或炎症细胞分布.结论 MRI在显示心脏黏液瘤大小、位置、形态,特别是评价肿瘤的组织学特征、血供及对心功能的影响,具有一定的价值.

MRI and pathologic correlation of cardiac myxomas

Objective To investigate the MRI features of cardiac myxoma by correlated with its pathological findings. Methods MRI features of 22 cases of pathologically confirmed cardiac myxomas were retrospectively reviewed. Results Of 22 cases, 21 are solitary, 12 located in left atrium, 6 located in right atrium, 2 located in left ventricle and 1 located in right ventricle. The other one occupied multiple chambers. MRI: 19 are heterogeneous and 3 are homogeneous. Cine-MRI: 18 attach to the endocardium with a pedunculated stalk and 4 are sessile and with a broad attachment. Thirteen cases had secondary valve insufficience or stenosis. Nine have compromised cardiac function. Nineteen cases demonstrated mild to moderate heterogeneous enhancement after Gd-DTPA administration and 3 ease showed no enhancement. Four cases had gadolinium first-pass perfusion study and showed a slow and continuous increasing time-intensity, lower than normal myocardium. The pedicles and wall showed delay enhancement. Pathologic findings: 21 are oval and lobalar configuration, 1 is grape-like. Ten cases had fresh hemorrhage and 5 had chronic hemorrhage. Fourteen had necrosis , 2 had cystic change and 4 had calcification. Blood vessels or inflanmmtory cells could be detected in 19 cases. Conclusions MRI can evaluate the size, location, morphology, especially the vascularity, histologic features and cardiac function of cardiac myxomas.