3例心脏占位病变的诊断经验

Diagnostic experience in 3 cases of cardiac occupying lesion

心脏占位病变的临床症状复杂,且缺乏行之有效的诊断学方法,给临床的诊断及治疗带来困难。笔者选取3例心脏占位病变(心房血管肉瘤、左室室壁瘤、左室憩室各1例),对比三者的临床特点、影像学检查(包括心脏超声、心脏CT和MRI)、术中所见及术后病理检查结果。分析三者在临床表现、占位病变的形态学、组织学、血流动力学等方面的差异,并以术中所见和病理学检查进一步核实诊断。发现心脏彩超、心脏CT血管成像术及MRI均有助于心脏占位病变的诊断,术前心脏占位病变的准确诊断有利于术式的选择,降低手术风险及有效评估术后转归。

The clinic symptoms of cardiac occupying lesions are complex and difficult to diagnose currently. In this study, three cases of atrial angiosarcoma, left ventricular aneurysm and left ventricular diverticulum were selected, respectively. The clinical characteristics, imaging features(echocardiogram, cardiac CT and MRI) and the postoperative and pathological results for patients were studied. We compared the differences in clinical symptoms, morphology, histology and haemodynamics among the three patients. The diagnosis were confirmed by intraoperative and postoperative pathological examination. We conclude that proper imaging approaches would be beneficial to diagnose the cardiac occupying lesions. Accurate preoperative diagnosis is beneficial to preoperative preparation as well as the decrease in operative risks.