实时三维超声心动图诊断原发性心房肿瘤价值研究

目的 探讨实时三维超声心动图(RT-3DE)对原发心房肿瘤的诊断价值.方法 应用RT-3DE检查30例原发心房肿瘤,所有病例均经手术和病理证实,术后ECG复查随访.结果 原发心房肿瘤的RT-3DE图像特征明显:根据RT-3DE图像特征对30例原发心房肿瘤全部做出正确诊断.所有心房肿瘤RT-3DE均实时显示与肿瘤大小相同的立体形态图像;心房黏液瘤立体形态图像与心房壁界限明显,都通过一短蒂与房间隔或心房壁相连,瘤体以蒂为固定点随心脏收缩、舒张在心房与房室瓣口之间往返运动;心房黏液瘤收缩期瘤体导致房室瓣相对关闭不全,舒张期瘤体导致房室瓣相对狭窄,但瘤体不引起房室瓣器质性病变,瘤体摘除后房室瓣功能即恢复正常;恶性心房肿瘤立体形态图像与心房壁关系密切,界限不明显,接触范围广泛,无蒂,瘤体不随心脏收缩、舒张运动.结论 RT-3DE比二维超声心动图更清晰显示原发心房肿瘤全貌形态,黏液瘤与恶性心房肿瘤图像特征差别明显,RT-3DE是诊断原发心房肿瘤简便、快捷和准确的检查方法,RT-3DE对原发心房肿瘤具有重要临床诊断价值.

Study on value of realtime three-dimensional echocardiography in diagnosis of primary atrial tumor

Objective] To investigate the value of realtime three-dimensional echocardiography(RT-3DE)on the diagnosis of primary atrial tumor.Methods] Thirty cases of primary atrial tumor were identified by RT-3DE,and were then confirmed by operation and pathology.The patients were followed up.Results] All of the 30 cases of primary atrial tumor were correctly diagnosed according to the image characteristic of RT-3DE.Primary atrial tumor has obvious characteristic on RT-3DE:All the atrial tumor display the same size of stereoimages as the tumor themselves.There is a clear boundary between the stereoimage of the myxoma and the atrial wall and there exists a short pedicle connecting the atrial myxoma to the atrial wall or the interatrial septum.The body of the atrial myxoma moves to and fro through the atrium and the atrioventricular valve with the contraction and relaxation of the heart with a fixative pedicle.Atrial myxoma leads to relative atrioventricular valve incompetence during systolic phase and relative atrioventricular valve stenosis during diastolic phase,but doesn't result in pathological changes of atrioventricular valve which restore to normal after exsection of the atrial myxoma.Malignant atrial tumor closely and extensively contact with atrial wall without obvious boundary,pedicle and movement with the contraction and relaxation of the heart.Conclusion] RT-3DE shows clearly full view of the primary atrial tumor than two-dimensional echocardiography and obvious image differences between atrial myxoma and malignant atrial tumor.It is a convenient,quick and precise modality for diagnosing primary atrial tumor and may be of significant clinical value for the diagnosis of primary atrial tumor.