心脏转移性黑色素瘤1例CMR表现特征

Characteristics of CMR Appearance in a Case of Cardiac Metastatic Melanoma

患者,53岁女性,两年前发现"左眼睫状体占位",行"左眼球摘除术",术后病理诊断为恶性黑色素瘤。现因"发现心脏杂音20 d"于我院就诊,结合心脏磁共振(cardiac magnetic resonance, CMR)影像特征(肿物在T1加权与T1加权压脂图像上均表现为高信号,提示短T1特征;肿物在T2加权表现为高信号,提示长T2特征;CMR首过灌注显示肿物呈不均匀灌注强化,晚期延迟扫描肿物呈不均匀延迟强化)及PET信号特点,考虑诊断为左眼恶性黑色素瘤心脏转移。此病例提示,多模态CMR心脏影像(T1加权、T2加权、首过灌注、延迟强化、功能电影等)可用于监测和早期发现黑色素瘤心脏转移,对于诊断黑色素瘤的患者建议常规进行心脏彩超筛查,对怀疑存在心脏受累的患者进一步行CMR检查,有助于早期发现并及时干预。

A 53-year-old woman was found "an occupant in the left ciliary body" two years ago and underwent the surgery of "left eye ball removal". Pathological results confirmed the diagnosis of malignant melanoma. The patient was admitted to our hospital again due to newly found heart murmur. With the combination of cardiac magnetic resonance(CMR) imaging characteristics, including high signals on T1-weighted and fat-suppressed T1-weighted images,the high signal on T2-weighted images, uneven first-pass perfusion and late gadolinium enhancement(LGE), as well as PET signal characteristics, the diagnosis of malignant melanoma cardiac metastasis was made. This case suggests that multimodality CMR, including T1-weighted, T2-weighted, first-pass perfusion, late gadolinium enhancement, and cine imaging, can be used to monitor and detect cardiac metastasis of melanoma in a relatively early stage. Therefore, we recommend a routine echocardiography screening for patients diagnosed with melanoma. In addition, CMR examinations and PET/CT may help early detection and timely intervention of melanoma cardiac metastasis, as for their good specificity in detecting, this disease in clinical practice.