心脏左心房占位性病变的超声诊断价值

Diagnostic value of echocardiography in space-occupying left atrium heart lesions

目的 探讨左心房占位性病变的超声心动图表现及超声心动图对其诊断价值.方法 超声检查诊断左心房占位性病变的患者66例,与其他影像学检查、临床治疗、手术病理、及随访结果进行对比.结果 66例左心房占位病变中血栓27例、左心房内及二尖瓣赘生物20例、左心房黏液瘤15例、副神经节瘤1例、左心房原发性肿瘤1例及转移瘤2例.典型声像特点：15例黏液瘤多有蒂,附着于房间隔卵圆孔边缘且活动度较大.27例左心房内血栓无蒂,活动性差,在形成及治疗的不同阶段表现不同.20例左心房内赘生物表现为二尖瓣或心内膜上附着团块状回声,大小不等,形态不规则,较大的赘生物难以与心脏肿瘤相鉴别,需结合临床表现及其他辅助检查诊断.左心房恶性肿瘤3例无蒂,活动性差,与心内膜界限不清,伴少量心包积液,CDFI检查团块内可见少许血流信号.心脏副神经节瘤1例位于主动脉副神经节内.结论 超声心动图是目前检出和评价左心房占位性病变的有效检查方法之一,能准确描述病变的部位、大小、数量、形状、活动性,以及与周围组织结构的关系和血流动力学改变.

Objective To explore the echocardiography manifestation of space-occupying lesions in left atrium and diagnostic value of echocardiography.Methods 66 cases of patients with ultrasound diagnosis of space-occupying lesions in left atrium unergone surgerywere followed.Results In the study of 66 cases of spaceoccupying lesions in left atrium,there were 27 cases of thrombus,20 patients with mitral valve vegetations and left atrial,15 cases of left atrial myxoma,1 paraganglioma.Left atrium of primary（1 case） and metastatic tumor（2case）.Many typical acoustic image characteristics were as follows：myxoma,were attached to the interatrial septum patent foramen edge and mobility.Thrombosis has no active,at various stages of the formation and treatment performance was different.Left atrial neoplasm characterized by mitral valve or adhered to the endocardial block echo,size,shape was irregular,Larger vegetations was hard to identify with cardiac tumors,need to be combined with clinical manifestations and other auxiliary examination to diagnose.Left atrium malignant tumor was no active,and endocardial boundary was not clear,with a small amount of pericardial effusion,CDFI：a little signal can be seen in the block.Heart paraganglioma was located in the left atrium or paraganglia aorta.Conclusion Echocardiography was the detection and evaluation tool of choice for space-occupying lesions in the left atrium,can accurately describe the lesion site,size,number shape,mobility,around the relationship between organization structure and hemodynamic changes.