心脏恶性肿瘤心肌超声造影表现的初步探讨

Preliminary study on the performance of myocardial contrast echocardiography in cardiac malignant tumor

目的探讨心脏原发性和继发性恶性肿瘤的心肌超声造影(MCE)表现。方法回顾性分析27例心脏恶性肿瘤患者的常规经胸超声心动图(TTE)、MCE及临床病理资料,根据病理及临床诊断结果分为原发肿瘤组6例和继发肿瘤组21例,比较两组TTE和MCE表现,计算并比较两组肿瘤与正常心肌超声造影剂峰值强度的比值(肿瘤A/心肌A)。结果 27例心脏恶性肿瘤患者中,MCE呈高增强19例,低增强8例。其中原发肿瘤组均呈高增强,继发肿瘤组呈高增强、低增强分别为13例、8例,两组增强程度比较差异无统计学意义(P=0.136)。原发肿瘤组和继发肿瘤组的肿瘤A/心肌A分别为2.31±0.65和1.25±0.51,差异有统计学意义(P<0.05)。直径≤5.0 cm的肿瘤呈高增强、低增强分别有3例、6例,直径>5.0 cm的肿瘤呈高增强、低增强分别有16例、2例,两者增强程度比较差异有统计学意义(P=0.006)。结论心脏原发恶性肿瘤MCE均呈高增强,心脏继发恶性肿瘤MCE呈高增强或低增强,直径>5.0 cm的心脏恶性肿瘤MCE多呈高增强。

Objective To explore the performance of myocardial contrast echocardiography（MCE） in primary and secondary cardiac malignant tumor.Methods Twenty-seven patients with cardiac malignant tumor were enrolled in this study,the data of routine transthoracic echocardiography（TTE）,myocardial contrast echocardiography（MCE）and pathological characteristics were analyzed retrospectively. 27 patients with cardiac malignant tumor were divided into primary tumor group（6 cases）and secondary tumor group（21 cases）according to the pathological and clinical diagnosis results.The difference of TTE and MCE in two groups were compared,and the ratio of tumor to normal myocardial echo contrast agent peak intensity（tumor A value or/myocardium A value） were calculated and compared.Results In 27 cardiac malignant tumor patients,19 patients showed high enhancement,while 8 patients showed low enhancement by MCE.All primary cardiac malignant tumors were highly enhanced,13 secondary cardiac malignant tumors were highly enhanced while 8 secondary cardiac malignant tumor were lowly enhanced.There were no significant differences in the enhancement degree between two groups（P=0.136）.Tumor A value/myocardium A value of primary and secondary cardiac malignant tumor were 2.31 ±0.65 and 1.25±0.51,respectively,and the differences were statistically significant（P0.05）.When the diameter of tumors were ≤5.0 cm,high and low enhancement were 3 cases and 6 cases,respectively.When the diameter of tumors were 5.0 cm,high and low enhancement were 16 cases and 2 cases,respectively,there were significant differences in MCE enhancement degree between tumor diameter ≤5.0 cm and 5.0 cm（P=0.006）.Conclusion The MCE of cardiac primary malignant tumor is highly enhanced and the cardiac secondary malignant tumor is highly or lowly enhanced.Most of the cardiac malignant tumors with a diameter 5.0 cm are highly enhanced by MCE.