小儿心脏横纹肌瘤多普勒超声心动图表现及诊断价值

    The clinical value and features of echocardiograghy in diagnosis of pediatric cardiac rhabdomyoma

    • 摘要: 目的:应用多普勒超声心动图观察小儿心脏横纹肌瘤的发生部位、大小、形态、活动度、血流动力学改变、心功能变化等特征,评估多普勒超声心动图对小儿心脏横纹肌瘤的诊断价值。方法:分析经手术及病理证实为心脏横纹肌瘤的13例患儿超声心动图的表现及诊断特点。结果:13例患儿多普勒超声心动图均发现心室腔内不同部位单个或多个等回声或强回声光团,回声均匀,境界清晰。其中5例为单发,8例为多发;瘤体单独位于右心室面7例,单独位于左心室面3例,左、右心室均有2例,同时累及左右心室及左心房1例;2例引起右心室流出道狭窄,1例引起右心室流入道梗阻;1例合并室间隔缺损,3例合并卵圆孔未闭,3例伴心律失常,3例伴心功能不全。结论:多普勒超声心动图因无创、重复性好、准确性高等优点被公认为诊断心脏横纹肌瘤的首选工具,其敏感性大于核磁共振,尤其适用于小儿心脏肿瘤的诊断。

       

      Abstract: Objective:To assess the value of echocardiograghy in diagnosing pediatric cardiac rhabdomyoma by detecting the tumor location,size,motion,morphometric,hemodynamic features and cardiac function changes.Methods:Cases were identified by searching the pediatric cardiac surgery records.The data of echocardiograghy information and diagnostic features of 13 children were reviewed.Results:Hyperecho or homogenous echo(single in 5 or multiple in 8) in different cavity of the heart were found in all cases.Echocardiograghy showed the right ventricular(RV) masses in 7 cases,the left ventricular(LV) masses in 3 casses,both RV and LV masses in 2 cases,and 1 case involving LV,RV,left atrium.Among the cases,1 case with ventricular septal defect,3 cases with patent foramen ovale,2 cases with right ventricular out troct obstruction and 1 case with right ventriculav inflow tract obstruction were detected.There were 3 cases with cardiac arrhythmias and other 3 cases with heart failure.Conclusions:Echocardiograghy has many advantages including non-invasive,repetitive,high accuracy and its diagnosis sensitivity is higher than MRI.As thus,cardiac ultrasound is preferred for clinical diagnosing cardiac rhabdomyoma,especially for children patients,but echocardiograghy can not give the final diagnosis results,it must relay on pathological histology diagnosis.

       

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