小儿原发性心脏肿瘤的超声心动图诊断及心功能评估

Echocardiography diagnosis of primary cardiac tumor in children and evaluation of cardiac function

目的探讨超声心动图诊断小儿原发性心脏肿瘤的临床价值,评价多普勒超声心肌活动指数(myocardialperformance index,MPI)估测心脏肿瘤患儿心功能的准确性。方法 58例心脏肿瘤患儿及58例正常儿童为研究对象,分析肿瘤患儿的超声心动图资料,并计算MPI。结果 16例手术者超声漏诊率为6%。58例肿瘤患者的左、右心室MPI与对照组无显著差异(P>0.05)。其中16例患儿行手术治疗,肿瘤手术组MPI较对照组明显升高(P<0.05),手术后多普勒超声MPI明显下降(P<0.05)。结论超声心动图可以准确的诊断心脏肿瘤的部位、大小、数目,但是不能确定肿瘤的性质;MPI可以准确反映肿瘤患者的心功能变化。

Objective To investigate the clinical value of echocardiography in children with primary cardiac tumor and to explore the accuracy of the Doppler myocardial performance index（MPI） in assessment of cardiac function.Methods Fifty eight children with primary cardiac tumors and 58 normal children were included in the study.The echocardiography features of cardiac tumor were retrospectively analyzed.Doppler LV and RV index were estimated by Doppler echocardiography.Results Fifteen cases with primary cardiac tumor were confirmed by surgery,1 case was miss diagnosed.The miss diagnostic rate was 6%.In children with primary cardiac tumor,left ventricular MPI was 0.33±0.07 vs 0.31±0.06 in normal subjects,while right ventricular MPI was 0.29±0.02 vs 0.27±0.08 in normal children.No significant difference was found between the two groups（P0.05）.In patients with operation,MPI was significantly higher preoperatively than those in the controls（P0.05） and significant decreased postoperatively（left ventricular MPI 0.26±0.05 vs 0.46±0.07,right ventricular MPI 0.24±0.03 vs 0.34±0.05,P0.05）.Conclusion Cardiac tumor could be accurately diagnosed by echocardiography,cardiac function could be assessed using MPI in patients with cardiac tumor.