电子束CT在心脏肿瘤诊断中的临床价值

Clinical application of EBCT in the diagnosis of cardiac neoplasms

目的 研究电子束CT(EBCT)在心脏肿瘤诊断中的临床价值。方法 自 1995年 7月至1999年 2月 ,行EBCT检查 12 0 2 4例 ,共诊断心脏肿瘤 40例 (占 0 33% )。本研究重点对有手术、尸检和临床随访结果的 2 2例进行回顾性分析。其中男 13例 ,女 9例 ;年龄从 5个月至 72岁 ,平均 41 9岁。 17例同时行单层增强和电影序列 ,3例单纯行单层增强 ,1例电影序列 ,1例单层平扫。结果 2 2个病例 ,EBCT均做出准确定量和定位诊断 ,10例黏液瘤病例 ,全部做出正确的组织病理学定性诊断 ;7例非黏液性良性肿瘤中 6例具特征性征象而提示正确的组织病理学诊断 ;5例恶性肿瘤中 4例做出正确组织学诊断 ,并显示了邻近脏器受累情况。结论 EBCT具有优良的时间、空间和密度分辨率 ,除对心脏黏液瘤诊断具有较高的准确性外 ,在对超声心动图难以准确定性的非黏液瘤性良、恶性肿瘤的诊断中尚具优势 ,同时可显示邻近脏器受累情况。对缺乏特异性的心脏肿瘤 。

Objective To probe the clinical utilization of electron beam CT (EBCT)in the diagnosis of cardiac neoplasms Methods Between July 1995 and Feb 1999, EBCT was performed in 12 024 patients in our hospital. 40 (0 33%) patients were diagnosed as cardiac neoplasms Retrospective analysis of 22 patients confirmed by operation, autopsy or follow up was done In this group ,there were 13 males and 9 females, age ranged from 5 months to 72 years old ( averaged 41 9 years) 17patients had both contrast single slice mode(contrast SSM)and movie mode, 3 patients only SSM, 1 patient movie mode and 1 patient plain SSM Results Accurate localization and quantitative diagnoses were made in all the 22 patients and correct histopathological diagnosis was made in 10 patients with myxoma EBCT provided characteristic clues to proper histopathological determination in 6 of the 7 patients with non myxomous benign neoplasms In the 5 patients with malignant masses, 4 patients acquired distinct histopathological classifications,and involvement of the adjacent anatomic structures was revealed Conclusion Because of excellent temporal, spatial and density resolution, EBCT has not only high accuracy in the diagnosis of myxoma, but also possesses advantage superior to echocardiography in the definition of non myxomous benign and malignant neoplasms,which are diffcult to diagnose histopathologically using echocardiography EBCT is also valuable for assessment of involvement of neigbouring organs In the diagnosis of cardiac neoplasm without specific features, this method is limited and difficult