心脏原发恶性肿瘤ct及mri表现

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1、-92-中国医学计算机成像杂志2006年第12卷第2期心脏原发恶性肿瘤CT及MRI表现杨姗张志勇曾蒙苏王佩芬陈财忠沈继章陈刚目的:了解心脏原发恶性肿瘤的CT、MRI表现,旨在提高诊断及鉴别诊断。材料和方法:12例经病理证实心脏恶性肿瘤的CT及MRI资料进行回顾性分析。其中5例行胸部CT平扫加增强扫描。9例做心脏MR检查,其中7例行动态增强扫描。结果:发生部位以右心房最多见(6/12)。跨心腔生长或累及邻近大血管及心包常见(10/12)。伴有心包和胸腔积液(9/12)。肿瘤多以中度不均匀强化为主,血管肉瘤内见同血管强化一致条状影,横纹肌肉瘤呈后期明显

2、均匀强化。肿瘤MR信号以T1WI等略低信号,T2WI为混杂高信号表现为主,而恶性纤维组织细胞瘤T2WI呈明显低信号较特征。结论:心脏恶性肿瘤具有一般恶性肿瘤侵袭性生长之特点,CT、MRI评价病变范围、组织特征具有优势,有助于诊断及治疗方案实施,进一步组织学定性、鉴别有困难。关键词心脏恶性肿瘤CT磁共振成像AppearanceofCTandMRIforPrimaryCardiacMalignantTumorYangShan,ZhangZhiyong,ZengMengsu,etalDepartmentofRadiology,ZhongshanHospi

3、tal,FudanUniversity,Shanghai200032Purpose:ToimprovetherecognitionofprimarycardiacmalignanttumorsbyanalyzingtheCTandMRIfindingsof12cases.MaterialsandMethods:CTandMRIfindingswerereviewedretrospectivelyin12patientswithcardiacmalignanciesprovenbypathology.Plainandcontrast-enhanced

4、chestCTscanswereperformedin5patients.9patientsunderwentcardiacMRscan,amongwhom7haddynamiccon2trast-enhancedscan.Results:Mostcommonchamberoforiginisrightatrium(6/12).Therearefre2quentinvolvementofmultiplechambers,vesselandpericardium(10/12).Concomitantpericardialorpleuraleffusi

5、onsoccurinabout75%(9/12)ofcasesofmalignanttumors.Thetumorsusuallydemonstrateaheterogeneousenhancementpatternaftercontrastmaterialadministration;whileobviousenhancedstriplinecanbeseeninangiosarcoma,andhomogeneousenhancementinrhabdomyosarcoma.Theneo2plasmsoftenhaveanisointenseap

6、pearanceonT1-weightedimagesandaheterogeneouspredominantlyhyperintenseappearanceonT2-weightedimages.Howevermalignantfibroushistiocytoma(MFH)ap2pearsaprominenthypointenseonT2-weighedimages.Conculsion:Primarycardiacmalignanceshaveinvasivebehaviorlikeothermalignanttumors.CTandMRim

7、agingareimportanttoolsintheevaluationoftheextentoftheinvolvementandtissuefeaturesofcardiacmalignances,whichishelpfulforen2hancingaccuratediagnosisandmakingtherapymanagement,buthistopathologicdiagnosisisadifficultproblembeforesurgery.KeywordsCardiacmalignancyCTMagneticresonance

8、imaging心脏原发恶性肿瘤极为罕见,尸检统计为0.001%～0.28%[1]。以往主要依赖心脏超声得以诊材料和方法断。