李炜，夏娟，孙庆军，马小静 ，王黎，陈鑫，熊青峰，彭志远

少见部位心脏黏液瘤的多层计算机断层摄影术和超声心动图诊断评价

李炜，夏娟，孙庆军，马小静 ，王黎，陈鑫，熊青峰，彭志远

目的：通过分析心脏多发或少见部位黏液瘤患者的影像学资料，探讨多层计算机断层摄影术（MSCT）和超声心动图对其联合检查的必要性。

方法：收集我院2003-02至2015-12经手术证实的14例多发和非起源于左心房卵圆窝的心脏黏液瘤，分析其MSCT征象，并与超声心动图结果对照。

结果：14例患者中超声心动图明确诊断12例，准确率约85.7%；MSCT诊断11例，准确率约84.6%。术前超声心动图和MSCT对此类多发或非常规位置起源心脏黏液瘤的诊断准确率基本相当且优势互补，超声心动图对于瘤体的运动、瘤蒂的位置、形态和附着点判断优于MSCT。而MSCT可同时排除有无肺动脉栓塞以及冠状动脉病变。

结论：多发或起源少见部位的心脏黏液瘤既有着与常规单发左心房黏液瘤相似的影像学表现，又有其特殊征象，两种检查方法密切结合，可对此类疾病及其并发症诊断达到较高的水平，为手术创造良好条件。

心脏黏液瘤，多发 ；体层摄影术，X线计算机

Abstract

Objective: To explore the necessity of multi-slice CT （MSCT） and echocardiogram in diagnosing multiple cardiac myxoma or myxoma originated from special site of heart via analyzing medical imaging features.

Methods: A total of 14 patients with multiple cardiac myxoma or myxoma not originated from left atrium fossa ovale were studied； the patients had operation confirmed diagnosis in our hospital from 2003-02 to 2015-12， the imaging features of MSCT and echocardiography were analyzed and compared.

Results: There were 12/14 patients diagnose by echocardiography with the accuracy of 85.7% and 11 patients diagnosed by MSCT with the accuracy of 84.6%. MSCT and echocardiography had similar pre-operative accuracy and complimentary advantages for diagnosing multiple cardiac myxoma or myxoma not originated from regular site of heart. Echocardiography was superior for examining the motion， pedicle position， shape and attachment point of cardiac myxoma； MSCT may exclude pulmonary embolism and coronary artery disease at meanwhile.

Conclusion: Unconventional cardiac myxoma not only has similar image signs to typical single myxoma from left atrium， but also has the specific features； MSCT combining echocardiogram examinations could make more accurate diagnosis and provide a better condition for surgical treatment.

（Chinese Circulation Journal， 2016，31: 844.）

心脏黏液瘤是临床上最常见的良性心脏肿瘤，有其特定的好发部位和典型的影像学特征，一般术前诊断不难，但临床往往发现一些较少见的病例，表现为非卵圆窝起源、多发、有家族发病倾向以及手术切除后易复发等特点，如何做到准确诊断，把握手术时机和术后随访，需要进行探讨。……