声学造影评估心内占位性病变血流灌注状况的初步探讨

Initial study on echocardiographic contrast perfusion imaging in cardiac masses

目的探讨心肌声学造影评估心腔内占位性病变血运状况的可能性。方法常规超声发现心腔内占位性病变后,经静脉行声学造影观察其灌注效果。结果共观察了2例患者心脏占位性病变灌注情况。其中:病例1为左心内占位性病变患者,经静脉注射声学造影剂后见该占位病变与心肌同步出现灌注显影。提示该病变血流丰富,术后病理证实为胚胎型横纹肌肉瘤。病例2为左心房内占位性病变患者,造影后未见该占位性病变显影。提示该病变为无血流病变,术后病理证实为血栓。结论声学造影方法可用于心内占位性病变血运状况的评估,对于判断病变的性质可能有一定的帮助。

Objective To investigate the usefulness of echocardiographic contrast peffusion imaging in differentiating cardiac masses. Methods Myocardial contrast echocardiograph was performed after cardiac mass detected by transthoracic echocardiography. Results Two patients with cardiac masses underwent cadence pulse sequencing imaging （CPS） after intravenous contrast agent administration. In one patient, contrast enhacement was found both in the mass and the myoeardium at the same time. In another patient, opacification was found only in myocardium not within the cardiac mass. The former case was diagnosed pathologically as embryonal rhabdomyosarcoma, and the later case was diagnosed pathologically as thrombi. Conclusions Echocardiographic contrast perfusion imaging would differentiate the neo - vascularization of malignancies from the avascnlarity of thrombi.