左房血栓和黏液瘤的超声背向散射积分研究

Clinical Study of Ultrasonic Tissue Characterization with Integrated Backscatter in Differential Diagnosis of Myxoma and Thrombus in Left Atrium

目的 探讨背向散射积分 (IBS)在心脏血栓及黏液瘤的鉴别诊断方面的价值。方法 对 18例左房血栓患者和15例黏液瘤患者 ,分别测量胸骨旁左室长轴切面血栓及左房黏液瘤的IBS值及其标化值 (IBS % ) ,部分病例与手术结果对照。结果 血栓的IBS值变化范围较大 ,从 18.0dB到 3 8.1dB ;黏液瘤的IBS值变化范围较小 ,从 2 4.7dB到 2 9.6dB ;黏液瘤的平均IBS值及IBS %较血栓的平均IBS值及IBS %低 ,二者间存在差异 (血栓和黏液瘤的平均IBS及IBS %分别为 2 7.9± 2 .8dB ,5 7.1± 9.3和 3 3 .4± 1.8dB ,67.3± 10 .6,P <0 .0 1)。结论 应用超声组织定征方法能准确地鉴别心脏黏液瘤与血栓。

Objective To determine if the ultrasonic integrated backscatter can be used in differential diagnosing myxoma and thrombus. Methods The integrated backscatter (IBS) and IBS% were measured in 18 patients with thrombus in left atrium and 15 patients with myxoma from the parasternal long axis view with HP 5500 ultrasonic system. The results of some patients were compared with those operated. Results The IBS of thrombus varied greatly from 18.0dB to 38.1dB while the IBS of myxoma varied little from 24.7 dB to 29.6 dB. IBS and IBS% of myxoma were lower than thrombus'. There was significant statistical difference between the two groups. (IBS and IBS% of thrombus and myxoma were 27.9±2.8 dB, 57.1±9.3 and 33.4±1.8dB, 67.3±10.6, respectively, P <0.01). Conclusion Ultrasonic tissue characterization with integrated backscatter can be used as a noninvasive approach in the differential diagnosis of myxoma and thrombus.