心脏超声在心内平滑肌瘤病中的诊断价值研究

Evaluation of echocardiography in the diagnosis of the intracardiac leiomyomatosis

目的评价心脏超声在心内平滑肌瘤病诊断中的临床价值。方法回顾性分析近两年来我院就诊的罹患心内平滑肌瘤病的患者共13例,所有患者确诊均经手术病理证实,分析患者临床症状体征和心脏超声表现。结果首发临床表现:7例心脏相关症状,4例静脉梗阻表现,2例盆腔包块;常见临床表现:呼吸困难、胸闷、胸痛、心悸、胸骨左缘收缩期杂音、水肿、腹胀及盆腔包块等;10例有子宫肌瘤、子宫静脉或宫旁静脉内平滑肌瘤病手术史。心脏超声表现:右心腔内随心动周期周期性摆动的条索状或团块状肿物回声,与下腔静脉或髂静脉肿物相连。结论心脏超声对心内平滑肌瘤病的准确诊断和术后随访具有重要的临床价值,推荐临床推广应用。

Objective To explore the clinical value of echocardiography in the diagnosis of the intracardiac leiomyomatosis. Methods 13 patients recurrently diagnosed with intracardiac leiomyomatosis in our hospital were involved as the research object,the diagnosis of which was confirmed by surgery pathology.Their clinical symptoms and echocardiography performance were analyzed. Results Starting clinical manifestations：7 cases with cardiac symptoms,4 cases with venous obstruction performance,2 cases with Pelvic mass;Common clinical manifestations：dyspnea,chest distress,chest pain,palpitation,sternum left edge systolic murmurs,edema,abdominal distension and pelvic mass;10 cases had a history of hysterectomy because of leiomyoma uteri,intravenous leiomyomatosis of uterine vein or veins beside the uterus.Echocardiography performance：the presence of a long,serpentine,polypoidal mass extending from the inferior vena cavainto the ringht atrium and swing in the cavity following the cardiac cycle should raise the suspicion of intravenous leiomyomatosis. Conclusion Echocardiography plays an important role in the diagnosis and follow-up survey of the intravenous leiomyomatosis,is worth of clinical popularization and application.