心脏原发恶性肿瘤CT及MRI表现

目的:了解心脏原发恶性肿瘤的CT、MRI表现,旨在提高诊断及鉴别诊断。材料和方法:12例经病理证实心脏恶性肿瘤的CT及MRI资料进行回顾性分析。其中5例行胸部CT平扫加增强扫描。9例做心脏MR检查,其中7例行动态增强扫描。结果:发生部位以右心房最多见(6/12)。跨心腔生长或累及邻近大血管及心包常见(10/12)。伴有心包和胸腔积液(9/12)。肿瘤多以中度不均匀强化为主,血管肉瘤内见同血管强化一致条状影,横纹肌肉瘤呈后期明显均匀强化。肿瘤MR信号以T1WI等略低信号,T2WI为混杂高信号表现为主,而恶性纤维组织细胞瘤T2WI呈明显低信号较特征。结论:心脏恶性肿瘤具有一般恶性肿瘤侵袭性生长之特点,CT、MRI评价病变范围、组织特征具有优势,有助于诊断及治疗方案实施,进一步组织学定性、鉴别有困难。

Appearance of CT and MRI for Primary Cardiac Malignant Tumor

To improve the recognition of primary cardiac malignant tumors by analyzing the CT and MRI findings of12cases.Materials and Methods:CT and MRI findings were reviewed retrospectively in12patients with cardiac malignancies proven by pathology.Plain and contrast-enhanced chest CT scans were performed in5patients.9patients underwent cardiac MR scan,among whom7had dynamic con-trast-enhanced scan.Results:Most common chamber of origin is right atrium(6/12).There are fre-quent involvement of multiple chambers,vessel and pericardium(10/12).Concomitant pericardial or pleural effusions occur in about75%(9/12)of cases of malignant tumors.The tumors usually demonstrate a heterogeneous enhancement pattern after contrast material administration;while obvious enhanced stripline can be seen in angiosarcoma,and homogeneous enhancement in rhabdomyosarcoma.The neo-plasms often have an isointense appearance on T 1 -weighted images and a heterogeneous predominantly hyperintense appearance on T 2 -weighted images.However malignant fibrous histiocytoma(MFH)ap-pears a prominent hypointense on T 2 -weighed images.Conculsion:Primary cardiac malignances have invasive behavior like other malignant tumors.CT and MR imaging are important tools in the evaluation of the extent of the involvement and tissue features of cardiac malignances,which is helpful for en-hancing accurate diagnosis and making therapy management,but histopathologic diagnosis is a difficult problem before surgery.