超声诊断三尖瓣黏液瘤一例并文献复习

The diagnosis of tricuspid valve myxomas by echocardiography: one case and literature review

目的结合病例及文献,探讨心脏瓣膜黏液瘤的超声心动图影像特征。方法回顾性分析本院诊治的三尖瓣黏液瘤一例,综合查体、影像学检查、手术及病理诊断,并结合文献报道,总结心脏瓣膜黏液瘤的临床表现、病理生理改变、超声心动图特征等。结果瓣膜黏液瘤极为罕见,临床表现为阻塞、栓塞及全身表现,由于附着于瓣膜,主要引起瓣膜启闭功能,造成瓣口狭窄或关闭不全,继而引起相应血流动力学改变,超声心动图下表现为以蒂附着于瓣膜的等回声或稍强回声团,随瓣叶启闭活动度大。结论瓣膜黏液瘤极为罕见,超声心动图可及时、有效诊断,是首选的影像学评价方法,联合经食道超声心动图能更好帮助评估该病。

Objective To investigate the echocardiographic features of cardiac valve myxoma in combination with cases and literature. Methods Retrospectively analyzed one case of tricuspid valve myxoma which was diagnosed and treated in our hospital. The clinical manifestations, pathophysiological changes and echocardiographic features of cardiac valvular myxoma were summarized in combination with literature. Results The valvular myxoma is extremely rare. Its clinical manifestations are obstruction, embolism and systemic manifestations. Because of its attachment to the valve, it mainly causes valve opening and closing function, resulting in stenosis or insufficiency of the valve orifice, and then causes corresponding hemodynamic changes. Echocardiographic manifestations are isoecho or slightly strong echo mass with pedicle attached to the valve, and its activity increases with the opening and closing of the valve. Conclusions The valvular myxoma is extremely rare. Echocardiography is the preferred imaging evaluation method for the timely and effective diagnosis of valvular myxoma. Combination of transesophageal echocardiography can better help to evaluate the disease.