心脏粘液瘤的MRI表现特征

发布时间：2018-04-22 12:32

本文选题：心脏肿瘤 + 磁共振成像　；参考：《临床放射学杂志》2017年05期

【摘要】：目的探讨心脏粘液瘤的MRI表现特征。方法搜集18例经手术及病理确诊的心脏粘液瘤患者资料,术前均行心脏MRI增强检查,采集心脏粘液瘤的电影序列、SE序列(T1WI、T2WI)或IR序列(Double IR、Tripple IR)、首过灌注及延迟增强序列图像,对心脏粘液瘤的数量、位置、大小、边缘、MRI信号特点、基底及运动特点、强化特点、心脏结构改变、血流动力学特点等影像表现特点进行分析。结果 18例心脏粘液瘤位于左心房者14例。10例肿瘤起源于房间隔,6例起源于心房的游离壁,2例起源于心室壁。9例肿瘤可见瘤蒂,9例肿瘤的基底较宽。10例粘液瘤表现为圆形或椭圆形,8例表现为分叶状。所有粘液瘤的电影序列信号都为低信号,低于心肌信号,T2WI序列或Tripple IR序列整体都表现为高信号或等高信号,明显高于心肌信号,3例可见内部混杂点状低信号。首过灌注皆表现为充盈缺损,6例粘液瘤早期增强和延迟表现为无强化,8例延迟增强表现为早期增强和延迟增强明显强化,4例表现为早期增强和延迟早期皆为轻度强化。血流动力学方面,2例心房起源的粘液瘤靠近房室瓣,随心动周期变化而进出心室。1例左房粘液瘤靠近右下肺静脉汇入左心房处,右下肺静脉可见轻度扩张。4例出现相应心房或心室扩大。结论心脏粘液瘤的MRI表现具有一定的特征性,MRI是诊断心脏粘液瘤的有效、重要检查方法。
[Abstract]:Objective to investigate the MRI features of cardiac myxoma. Methods the data of 18 patients with cardiac myxoma confirmed by operation and pathology were collected. Cardiac MRI enhancement was performed before operation. The SE sequence of cardiac myxoma (T1WI T2WI) or IR sequence double IRI / Tripple IRI were collected, and the first perfusion and delayed enhancement images were obtained. The number, location, size, MRI signal characteristics, basal and motion characteristics, enhancement characteristics, changes of cardiac structure and hemodynamics of cardiac myxoma were analyzed. Results in 18 cases of cardiac myxoma, 14 cases were located in left atrium. 10 cases of tumor originated from atrial septum. 6 cases of free wall originated from atrium. 2 cases originated from 9 cases of ventricular wall tumor. 9 cases of ventricular wall tumor showed tumor pedicle. 10 cases of myxoma surface of 9 cases. There were 8 cases with round or oval shape. In all myxomas, the signal intensity of the film sequence was low, and the signal intensity was high or isointense in all cases, which was obviously higher than that in 3 cases of myxoma, which was obviously higher than that in the 3 cases of myxoma with interior-mixed dot hypointensity. The signal intensity was lower than that on T _ 2WI or Tripple IR sequences. Early enhancement and delayed enhancement were found in 6 cases of filling defect myxoma and 8 cases of delayed enhancement without enhancement. Early enhancement and delayed enhancement were obviously enhanced in 4 cases, early enhancement and delayed early enhancement were all mild enhancement in 4 cases. In hemodynamics, 2 cases of atrial myxoma were located near the atrioventricular valve, and 1 cases of left atrial myxoma entered the left atrium with the change of cardiac cycle, and the left atrial myxoma was close to the right inferior pulmonary vein to enter the left atrium. Mild dilatation of right inferior pulmonary vein was observed in 4 cases. Conclusion MRI of cardiac myxoma is an effective and important method for the diagnosis of cardiac myxoma.
【作者单位】：浙江大学金华医院医学影像科;浙江大学医学院附属邵逸夫医院放射科;
【基金】：金华市科学技术局社会发展类重点项目(编号:2014-3-009)
【分类号】：R445.2;R732.1

【参考文献】