儿童心脏横纹肌瘤的CT诊断

CT diagnosis of cardiac rhabdomyoma in childhood

目的 探讨儿童心脏横纹肌瘤的CT征象.方法 对经CT检查并经手术病理证实的5例心脏横纹肌瘤进行分析.4例行电子束CT（EBCT）增强扫描,1例行64层MSCT增强扫描.以横断面成像为基础,辅以三维重组充分显示病变.结果 （1）4例瘤体呈起自房室间隔的多发大小不等结节,其中1例尚见肿物起自左右心室前壁.1例肿物起自二尖瓣根部.（2）增强后肿物CT值80～180 HU,与邻近左心室肌壁相似.（3）心室流出道阻塞狭窄3例,其中1例尚见心包积液与左肺下叶感染.结论 儿童心脏CT增强检查发现起自房室间隔、与邻近左心室肌壁CT值相似的多发结节样肿物,伴或不伴结节性硬化,应首先考虑横纹肌瘤.

Objective To investigate the CT findings of cardiac rhabdomyoma in childhood. Methods Five children with cardiac rhabdomyoma confirmed by operation was retrospectively analysed. Enhanced electron beam CT （EBCT） was performed in 4 children and enhanced 64-slice helical CT （MSCT） scan was performed in 1 infant. Three dimensional reconstruction was applied for the full display of the lesions based on the transverse section images. Results （ 1 ） Multiple masses or nodules originated from atrioventricular septum were observed in 4 children including 1 nodule from the anterior walls of the left and right ventricles. A mass was derived from the mitral valve in 1 infant （2） The CT value of the lesions after enhancement ranged from 80 to 180 HU and was similar to neighbouring left ventricular myocardium. （3） The ventricular outlet obstruction was found in 3 children including 1 infant with pericardial effusion and pulmonary inflamation of the right lower lobe. Conclusion The rhabdomyoma should be considered first when masses or nodules originated from atrioventricular septum and with the enhancement similar to neigbouring left ventricular myocardium in children.