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目的探讨实时三维超声心动图(RT-3DE)对原发心房肿瘤的诊断价值。方法应用RT-3DE检查30例原发心房肿瘤,所有病例均经手术和病理证实,术后ECG复查随访。结果原发心房肿瘤的RT-3DE图像特征明显:根据RT-3DE图像特征对30例原发心房肿瘤全部做出正确诊断。所有心房肿瘤RT-3DE均实时显示与肿瘤大小相同的立体形态图像;心房黏液瘤立体形态图像与心房壁界限明显,都通过一短蒂与房间隔或心房壁相连,瘤体以蒂为固定点随心脏收缩、舒张在心房与房室瓣口之间往返运动;心房黏液瘤收缩期瘤体导致房室瓣相对关闭不全,舒张期瘤体导致房室瓣相对狭窄,但瘤体不引起房室瓣器质性病变,瘤体摘除后房室瓣功能即恢复正常;恶性心房肿瘤立体形态图像与心房壁关系密切,界限不明显,接触范围广泛,无蒂,瘤体不随心脏收缩、舒张运动。结论RT-3DE比二维超声心动图更清晰显示原发心房肿瘤全貌形态,黏液瘤与恶性心房肿瘤图像特征差别明显,RT-3DE是诊断原发心房肿瘤简便、快捷和准确的检查方法,RT-3DE对原发心房肿瘤具有重要临床诊断价值。
Objective To investigate the value of real-time three-dimensional echocardiography (RT-3DE) in the diagnosis of primary atrial tumor. Methods Thirty patients with primary atrial tumor were examined by RT-3DE. All the cases were confirmed by operation and pathology. The postoperative ECG was followed up. Results The characteristics of RT-3DE images of primary atrial tumor were obvious: all 30 cases of primary atrial tumor were correctly diagnosed according to RT-3DE image features. All the atrial tumors RT-3DE real-time display with the size of the tumor with the same three-dimensional morphological images; atrial myxoma stereoscopic morphology and atrial wall boundaries clearly through a short pedicle and atrial septal or atrial wall connected to the tumor as a fixed point With the heart contraction, diastolic in the atrium and atrioventricular valve between the back and forth movement; atrial myxoma shrinkage of the tumor leads to relative closure of atrioventricular valve, diastolic tumor causes atrioventricular valve is relatively narrow, but the tumor does not cause atrioventricular Aortic valve disease, tumor removal of atrioventricular valve function is normal; malignant atrial tumor stereoscopic images closely related with the atrial wall, the boundary is not obvious, wide range of contact, pedicle, the tumor does not shrink with the heart, diastolic exercise. Conclusion RT-3DE clearly shows the morphology of the primary atrial tumor more clearly than the two-dimensional echocardiography. The features of the images of the myxoma and malignant atrial tumor are distinctly different. RT-3DE is a simple, rapid and accurate method for the diagnosis of primary atrial tumors. -3DE has an important clinical diagnostic value for primary atrial tumors.