心腔内血性囊肿的超声心动图影像学特征及诊断方法

Echocardiographic Features and Diagnostic Approach of Intracardiac Blood Cyst

目的:总结心腔内血性囊肿(CBC)的超声心动图影像学特征及诊断方法。方法:回顾性分析2009年12月至2020年11月我院外科手术及病理诊断确诊的CBC患者13例,分析其超声心动图影像学特征、诊断准确率及诊断方法。结果:13例CBC患者中,3例位于二尖瓣,5例位于三尖瓣、2例位于主动脉瓣,3例位于右心房内。CBC具有典型的影像学特征:囊肿多为单发、类圆形囊性,大小不一,直径范围约3~40 mm;囊内可有或无分隔,形态呈“花瓣样”或“灯泡状”;囊壁薄而光滑、可见钙化点;囊肿于附着位置随心动周期摆动。术前超声心动图准确诊断9例(准确率69.2%);无误诊发生;漏诊4例(漏诊率30.8%)。漏诊原因主要是CBC体积微小或受周围组织声影遮盖导致超声心动图未探查到。13例患者均接受CBC切除术,术后超声心动图中位随访7.1(1.5,13.7)个月,无1例CBC复发,无严重并发症发生。结论:CBC具有典型的超声心动图影像学特征,可明确诊断。微小CBC会因超声心动图探查切面不够而漏诊。CBC可以通过手术切除获得根治。

Objectives:To summarize the echocardiographic features and diagnostic approach of intracardiac blood cyst(CBC).Methods:Clinical data from 13 CBC patients,who were diagnosed by surgical and pathological examinations between December 2009 and November 2020,were retrospectively analyzed,and their echocardiographic features,diagnostic accuracy and diagnostic approach were summarized.Results:Among the 13 CBC patients,3 were located in the mitral valve,5 were located in the tricuspid valve,2 were located in the aortic valve,and 3 were located in the right atrium.CBC had following typical imaging features:Cysts were mostly single and round cystic,with different sizes and a diameter range of about 3-40 mm;with or without separation in the cyst,the shape was"petal like"or"bulb like";the cyst wall was thin and smooth,and calcification points can be visualized;the cyst oscillated freely and periodically at the attachment position.Nine cases were diagnosed by preoperative echocardiographic examination accurately(accuracy rate:69.2%).None was misdiagnosed(misdiagnosis rate:0.0%).Four cases were missed diagnosed(missed diagnosis rate:30.8%).CBCs were missed diagnosed because of the small size or CBCs were covered by the shadow of surrounding tissues.All patients received successful surgical CBC resection.The median postoperative follow-up time by echocardiography was 7.1(1.5,13.7)months.There were no CBC recurrence and no serious postoperative complications during follow up period.Conclusions:CBC has typical echocardiographic features,which can be correctly diagnosed by echocardiography examination.It is difficult to correctly diagnose the Micro CBC due to insufficient ultrasound exploration.CBC can be cured by surgical removal.