原发性心脏肿瘤的超声心动图诊断价值

Value of echocardiography in primary cardiac tumors

目的:探究原发性心脏肿瘤的超声心动图诊断特征及价值。方法:选择2012年4月-2014年6月收治的均经手术病理确诊的155例原发性心脏肿瘤患者,回顾性分析患者的超声心动图、病理学等临床资料,总结其超声心动图特征。结果:155例原发性心脏肿瘤患者中,良性肿瘤患者121例,其中男性48例,女性73例,女性多于男性(P<0.05)。恶性肿瘤患者34例,男性15例,女性19例,女性多于男性,但差异性不显著(P>0.05)。良性肿瘤患者的比例显著高于恶性肿瘤患者,具有明显差异(P<0.05)。良性黏液瘤多发于成人以及老年人,良性非黏液瘤以儿童、成人多见,恶性肿瘤多发于40岁以上成年人;黏液瘤在良性肿瘤中比例为62.8%,比例最大,良性非黏液瘤包括纤维瘤(3.3%)、横纹肌瘤(7.4%)、脂肪瘤(16.5%)、乳头状弹性纤维瘤(8.3%)以及血管瘤(1.7%),恶性肿瘤包括血管性肉瘤(17.6%)、横纹肌肉瘤(17.6%)、纤维组织细胞瘤(14.7%)、间叶肉瘤(8.8%)、平滑肌肉瘤(17.6%)以及未分类肉瘤(23.5%)。在良性肿瘤患者中,同时累及左心房与左心室的比例为79.3%,同时累及右心房与右心室的比例为11.6%,心包受累比例为5.8%,其他部位3.3%,各个部位受累比例具有明显差异性(P<0.05)。在恶性肿瘤患者中,受累比例最高的是右心房与右心室,其次是左心室与左心房、心包,其他部位为11.8%,各个部位受累比例具有明显差异性(P<0.05)。良性肿瘤与恶性肿瘤患者在各个部位受累的比例差异性明显,具有统计学意义(P<0.05)。结论:利用超声心动图检测原发性心脏肿瘤患者,能够较清晰区分不同病理的肿瘤患者的受累部位,对临床研究具有一定的指导作用。

Objective：To explore the primary cardiac tumors echocardiographic diagnostic features and value. Methods：All 155 cases of primary cardiac tumors were analyzed. Results：In 155 cases of primary cardiac tumors there were benign tumors 121 cases,48 cases were males,females 73 cases,more women than men（P 〈 0. 05）. 34 ca-ses of cancer patients,15 males and 19 females（P 〉 0. 05）. The proportion of patients with benign tumors was signifi-cantly higher than patients with malignant tumors（P 〈 0. 05）. Benign myxoma mainly in adults and the elderly,non -benign myxoma with children and adults more common,malignancies mainly in the elderly. Mucus benign tumors was 62. 8% ,non - benign myxoma including benign fibroma（ 3 . 3 % ）,rhabdomyosarcoma tumors（7. 4% ）,lipoma （16. 5% ）,papillary fibroelastoma（8. 3% ）and hemangioma（1. 7% ）,patients with malignant including vascular tumors meat（17. 6% ）,rhabdomyosarcoma（ 17 . 6 % ）,fibrous histiocytoma（ 14 . 7 % ）,mesenchymal sarcoma （8. 8% ）,leiomyosarcoma（17. 6% ）and unclassified sarcoma（23. 5% ）. In patients with benign tumors,involved left ventricle and left atrium was 79. 3% ,right atrium and right ventricle ratio 11. 6% ,5. 8% pericardial involvement, other parts 3. 3%（P 〈 0. 05）. In cancer patients,the highest percentage of involvement was the right atrium and right ventricle. Conclusion：Echocardiography in patients with primary cardiac tumors,can more clearly distinguish patients with different tumor pathology has a guiding role.