摘要
目的总结超声心动图诊断儿童及青少年心脏肿瘤的特点及临床治疗经验。方法纳入2013年1月至2020年1月于首都医科大学附属北京安贞医院儿童心血管病中心住院治疗的心脏肿瘤患儿,对其超声心动图表现及临床资料进行回顾性分析。结果 24例患儿进入本文分析,20例行肿瘤完整切除术,4例行肿瘤部分切除术。术后病理显示良性病变19例(79.2%),恶性病变1例(4.2%),生物学行为未明性肿瘤4例(16.7%);黏液瘤7例,横纹肌瘤6例,炎性肌纤维母细胞瘤4例,纤维瘤3例,纤维肉瘤、畸胎瘤、血管瘤和血栓各1例。心脏肿瘤发生部位以右心室、左心房多见。超声诊断与手术后病理诊断符合率29.2%(7/24)。黏液瘤超声表现特异性强,超声与手术后病理诊断符合率85.7%(6/7),黏液瘤的超声特征性表现包括:低至中等回声,分叶状,形态不规则,结构松散,活动度大,均有蒂附着;形态会随心脏的收缩和舒张改变,舒张期瘤体不同程度嵌入房室瓣口,引起房室瓣继发狭窄。结论儿童心脏肿瘤以良性肿瘤多见,病理类型以黏液瘤、横纹肌瘤为主。黏液瘤超声诊断符合率高。
Objective To summarize the echocardiographic features and clinical treatment experience of cardiac tumors in children and adolescents.Methods The hospitalized cases of cardiac tumors between January 2013 and January 2020 were selected from Pediatric Cardiovascular Center of Beijing Anzhen Hospital Affiliated to Capital Medical University.The echocardiographic features and clinical data were retrospectively analyzed and summarized.Results A total of 24 patients were included into the analysis.Complete tumor resection was performed in 20 patients and partial resection was performed in 4 patients.Postoperative pathology showed benign lesions accounted for 79.2%(19/24),malignant lesions for 4.2%(1/24)and tumors of uncertain biological behavior for 16.7%(4/24).Among them,there were 7 cases of myxoma,6 cases of rhabdomyomas,4 cases of inflammatory myofibroblastoma,3 cases of fibroma,1 case of fibrosarcoma,teratoma,hemangioma and thrombus for each.The right ventricle and left atrium were main sites of cardiac tumors.Diagnosis accuracy of echocardiography for cardiac tumors was 29.2%(7/24),and it was 85.7%(6/7)for myxoma due to the high specificity of echocardiography.The echocardiographic features of myxoma included low to moderate echoes,lobulation,irregular shapes,loose structures,high mobility,and attached pedicles.Shapes of myxoma changed with the contraction and relaxation of the heart,and the tumor was embedded in the atrioventricular valve opening to different degrees during diastole,causing secondary stenosis of the atrioventricular valve.Conclusion Benign tumors are more common in children and adolescents.The common cardiac tumors are rhabdomyomas and myxoma.Diagnosis accuracy of echocardiography is high for myxoma.
作者
杨爽
耿斌
李文秀
苏俊武
吴江
YANG Shuang;GENG Bin;LI Wen-xiu;SU Jun-wu;WU Jiang(Pediatric Cardiovascular Center,Beijing Anzhen Hospital affiliated to the Capital Medical University,Beijing 100029,China)
出处
《中国循证儿科杂志》
CSCD
北大核心
2020年第3期196-200,共5页
Chinese Journal of Evidence Based Pediatrics
关键词
心脏肿瘤
超声心动图
儿童
外科治疗
Cardiac tumor
Echocardiography
Children
Surgical treatment
