心脏原发性肿瘤的超声鉴别诊断

目的：探讨心脏粘液瘤、脂肪瘤和横纹肌瘤的超声鉴别诊断。材料和方法：利用超声心动图检查３６ 例心脏肿瘤,其中粘液瘤３０ 例,脂肪瘤４ 例,横纹肌瘤２ 例。均经手术病理证实。通过左室长轴、短轴、四腔和五腔心等切面观察肿瘤的部位、形态、包膜、活动度、界线和回声特征。结果：粘液溜多发生在左房,有明确的瘤蒂,肿瘤活动度较大,有分叶。脂肪瘤与粘液瘤不同处是多发生在左室,活动度较小,有漂浮感,肿瘤回声较强,没有分叶。横纹肌瘤发生在室壁心肌内,肿瘤与正常心肌间有明确的界线。结论：超声心动图对心脏原发性肿瘤的鉴别诊断具有重要意义。     

原发性心脏肿瘤超声心动图诊断

目的探讨原发心脏肿瘤超声心动图(ECG)特征。资料和方法100例原发心脏肿瘤。年龄6～68(平均42．5)岁。应用ECG检查后99例手术，1例尸解证实。结果ECG对97例心腔内粘液瘤全部做出正确诊断，2例心肌纤维瘤和1例二尖瓣叶脂肪瘤提出相应部位占位病变。结论心脏粘液瘤与心内膜界限明显，都有蒂与心内膜相连，瘤体以蒂为定点随心脏收缩舒张往返摆动，其它肿瘤与正常心肌无明显界限且无蒂；心房粘液瘤可致房室瓣狭窄和关闭不全，瘤体摘除后房室瓣功能即恢复正常；ECG是诊断原发心脏肿瘤简便、快捷、准确的检查方法。     

原发性心脏心包肿瘤的MRI诊断分析

目的：分析原发性心脏心包肿瘤的ＭＲＩ所见，评价ＭＲＩ对本病诊断的意义。材料和方法：１４例原发性心脏心包肿瘤均经ＭＲ检查，男９例，女５例。年龄６个月～６４岁，平均４４岁，其中儿童２例。１４例中８例经手术病理证实６例经ＭＲ和超声诊断。所有病例ＭＲ扫描前均有Ｘ线平片检查。结果：１４例心脏心包肿瘤中心腔内肿瘤５例，证实为粘液瘤，４例位于左房，１例位于左室。肌壁肿瘤６例，１例证实为淋巴管瘤。心包肿瘤３例，２例证实为脂肪瘤和间皮肉瘤。结论：ＭＲ对心脏心包肿瘤具有诊断价值，更适于全面观察肿瘤对心肌的浸润和向腔内外扩散及其与心旁肿瘤的鉴别     

心脏粘液瘤

心脏肿瘤较少见，而心脏粘液瘤为其中最常见的原发性心脏肿瘤，本文收集了自1978年至1986年我院经手术证实的心脏粘液瘤42例，以X线表现和诊断方法作为重点，并复习文献进行讨论。     

超声心动图诊断心脏恶性肿瘤

超声心动图诊断心脏恶性肿瘤王廉一李越温朝阳心内肿瘤良性者多见，且以心房粘液瘤居多。恶性肿瘤虽占心脏肿瘤的比例较小，但其预后差，及时诊断，有助于治疗。超声诊断易与良性肿瘤混淆。本文报道两例心脏恶性肿瘤的超声表现及诊断。１病例报导例１男，４２岁。因劳力性...     

CT在诊断心房肿瘤的价值

CT 检查是非损伤性的,可以清晰地显示左房粘液瘤的大小、位置和形态。约3/4良性心脏肿瘤位于左房,1/4在右房,除少数例外均为粘液瘤。70%的粘液瘤起始于房间隔的卵圆孔区。瘤体有蒂与间隔相连,罕有与间隔牢固附着。作者在2年内借助于超声心动图及CT 证实心房粘液瘤6例,5例作了血管造影、手术及组织学证实。     

原发性心脏心包肿瘤的MRI诊断

目的；评价MRI在原发性心脏心包肿瘤诊断中的价值。资料与方法：回顾分析14例经手术病理或临床证实的原发性心脏心包肿瘤的MRI表现，并与ICG检查结果比较。结果：除1例右心房粘液瘤漏诊，1例定位错误外，其余定位和良恶性定性均正确，10例术前组织学定性正确，与MRI比较，UCG另有3例定位定性错误，结论：MRI对心腔内肿瘤不仅定位准确，还多可定性；对肌壁肿瘤的良，恶性区别也有重要价值。对心包肿瘤多因其好发部位与特殊信号诊断不难，MRI是诊断和评价原发性心脏心包肿瘤重要的影像检查方法。     

MRI联合超声诊断胎儿结节性硬化症

【摘要】目的：探讨胎儿结节性硬化症（TSC）的产前MRI诊断方法及影像特征。方法：回顾性分析产前MRI联合超声诊断为TSC的14例胎儿资料,并总结其影像特征。MRI主要采用快速成像即HASTE序列及DWI序列,部分胎儿结合T1WI (FL2D)扫描。结果:产前超声筛查发现心脏横纹肌瘤胎儿共22例,MRI检查发现14例胎儿脑部见室管膜下结节,5例同时合并脑皮质结节。14例胎儿均诊断为TSC。胎儿脑部结节表现为T1WI稍高信号,HASTE序列低信号结节,以HASTE序列显示最佳。本组14例TSC胎儿9例终止妊娠引产,其中2例引产后标本解剖病检,证实为心脏横纹肌瘤伴颅内结节;5例出生后随访证实为TSC。结论：产前超声检查可准确诊断胎儿心脏横纹肌瘤。超声提示心脏横纹肌瘤后,MRI对诊断胎儿TSC颅脑病变敏感性高。MRI联合超声可以确诊胎儿TSC。     

小肠平滑肌肿瘤的血管研究

目的：观察小肠平滑肌肿瘤血管形态。方法：对８例正常小肠标本及１０例（１５个瘤体）经病理证实的平滑肌瘤手术切除标本，采用血管造影、解剖镜观察、石蜡切片光镜观察及图像分析。结果：小肠平滑肌肿瘤血管丰富，共同特征是：供血动脉增粗，沿瘤蒂进入瘤中心，呈放射状分布、簇状增生、丰富吻合，形似“蜘蛛网”状。血管扭曲、中断，瘤体内造影剂池明显者提示平滑肌肉瘤。结论：小肠平滑肌肿瘤属多血供肿瘤，良、恶性之间血管存在一定特点。这有助于介入诊断及螺旋ＣＴ诊断。     

彩色多普勒超声对睾丸肿瘤的诊断价值

目的：总结51例睾丸肿瘤的声像图特征。探讨超声对睾丸肿瘤的诊断价值。方法：分析51例经手术后病理证实的睾丸肿瘤的二维及彩色多普勒超声特征。结果：51例睾丸肿瘤中。恶性肿瘤36例(70．58％)，良性肿瘤15例(29．41％)。36例恶性肿瘤中。精原细胞瘤18例(35．29％)，恶性淋巴瘤6例(11．76％)，胚胎瘤、恶性畸胎瘤及内胚窦瘤各3例(各占5．88％)，卵黄囊瘤、间质细胞瘤及胚胎性横纹肌肉瘤各1例(各占1．96％)。15例良性肿瘤中。畸胎瘤8例(15．69％)，皮样囊肿4例(7．84％)，毛细血管瘤2例(3．92％)，良性增生1例(1．96％)。肿瘤呈不均匀等回声或略低回声。部分有散在高回声，其边界清楚。恶性肿瘤血流丰富，良性肿瘤的血流与正常睾丸组织无明显差异。结论：超声检查对皋丸肿瘤的诊断及鉴别很高的价值，能为临床诊断及治疗提供可靠信息。     

CT and MR imaging findings of benign cardiac tumors

This imaging review describes the appearance of benign cardiac tumors on CT and MRI. Although rare, benign tumors outnumber their primary malignant counterparts three to one. Since mortality varies directly with invasion, identifying the neoplasm at an early stage helps focus treatment, especially in benign cases, which generally respond well to surgical resection. In adults and children, myxomas and rhabdomyomas, respectively, represent the most common benign tumors, which can be grouped into tissue-specific subtypes, such as rhabdomyomas, fibromas, lipomas, teratomas, etc. Besides their variable prevalence in particular age groups, these tumors also differ with regard to their gender predilection, location, and number. For example, myxomas appear predominantly in women and generally as a solitary mass in the left or right atrium, whereas rhabdomyomas present equally in boys and girls and chiefly as multiple masses in the ventricles. Despite their differences, however, both types share an association with heritable syndromes like the Carney complex for myxomas and tuberous sclerosis for rhabdomyomas. As with all cardiac tumors, echocardiographic findings usually suggest the initial diagnosis but cross-sectional imaging with CT and MRI can help resolve diagnostically challenging cases. For example, with its direct multiplanar capability, excellent contrast resolution, and large field of view, MRI permits a detailed examination of the entire mediastinum, helping to rule out an equivocal mass on echocardiography. Through dynamic techniques, MRI, in addition to morphologic characterization, can depict the pathophysiological effects of these tumors, for instance, with regard to myocardial contraction, valvular function, or blood flow.     

MR imaging of pediatric cardiac tumors previously diagnosed by echocardiography

Ten children, ranging in age from 3 weeks to 11 years, with a history of primary cardiac tumors were studied by two-dimensional echocardiography and by ECG triggered magnetic resonance (MR) imaging (six of them had rhabdomyomas). Eighteen of 31 tumors with intracavitary extension diagnosed by echocardiography were detected by MR. In addition, three intracavitary tumors were found by MR but not by echocardiography. Only 2 of 15 intramural tumors detected by echocardiography were identified by MR. Magnetic resonance imaging is inferior to echocardiography in the detection of intramural rhabdomyomas, but superior in delineation of the intra- and extracardiac extension of nonrhabdomyomal tumors.     

心脏原发恶性肿瘤CT及MRI表现

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。     

原发性心脏肿瘤（非粘液瘤）的影像学诊断

目的：研究与比较原发性心脏肿瘤的各种影像学特征性表现及其诊断价值。材料和方法：1957年至1994年间经手术病理证实原发性心脏肿瘤17例。良性11例(海绵状血管瘤2例、错构瘤2例、纤维瘤4例、纤维间皮瘤2例、脂肪组织浸润1例)．恶性6例(平滑肌肉瘤2例、血管肉瘤4例)。影像学检查有：胸片(正侧位）及UCG各17例：CT2例；MRI4例；ACG(电影或DSA)9例；冠状动脉造影3例。结果：X线平片检查无特征性表现，UCG征象为云絮状或团块状回声(敏感性100%)。MRI图像能显示肿块轮廓．大小、与心腔壁的关系及有无心包积液等．优于一般CT，ACG（DSA或Cine)能在动态下观察肿瘤对血液动力学的影响及与周围组织(如瓣膜、大血管等）的关系．结论：UCG及MRI对心脏肿瘤诊断敏感性高，且能同时显示心包及心肌的改变，能确诊．应作为首选和必需的检查方法。ACG在准备手术的病例中应用。不同性质肿瘤之间鉴别困难。     

原发性小肠肿瘤的诊断

为探讨如何提高对原发性小肠肿瘤的诊断水平,对我院６４例经手术和病理证实的原发性小肠肿瘤进行了回顾性分析。结果：术前确诊３４例,确诊率为５３．１％;误诊３０例,误诊率为４０．９％。经手术及病理证实,良性２２例,恶性４２例,良恶性比为１：１．９。良性肿瘤以腺瘤、平滑肌瘤、脂肪瘤及胆管瘤多见,恶性肿瘤以腺癌、恶性淋巴瘤和平滑肌肉瘤多见。良性多位于空回肠,恶性腺癌多位于十二指肠,恶性淋巴瘤和肉瘤多位于空回     

Magnetic resonance imaging of myxoid containing tumors

Myxoid tissue forms part of many benign and malignant soft-tissue tumors. The advent of percutaneous needle biopsy has made it important to be aware of the diagnostic implications of biopsy samples containing myxoid tissue. To determine whether the magnetic resonance imaging (MRI) characteristics could help establish the diagnosis, we compared the MR images of 11 tumors containing myxoid tissue with the resected tumor tissue. In our small series of these rare tumors, the MRI characteristics allowed differentiation of intramuscular myxomas from malignant neoplasms containing myxoid tissue. Intramuscular myxomas meet the following conditions: (a) they are well circumscribed; (b) they arise within muscle; (c) T₁-weighted images demonstrate uniform, decreased signal intensity; (d) T₂-weighted images demonstrate uniform increased signal intensity; (e) contrast-enhanced images exhibit an inhomogeneous increase in signal intensity. If any of these conditions is not met, then a malignancy containing myxoid tissue should be suspected.     

Cardiac rhabdomyosarcoma

BACKGROUND: Primary malignant cardiac tumors are rare entities and rhabdomyosarcoma accounts 20% of these lesions. CASE REPORT: We presented a female patient with loss of appetite and loss of weight. She also had symptoms of heart failure and bilateral pleural effusions. A mobile tumor in the left heart with the entrance from the left atrium to left ventricle during diastole was seen by transthoracic echocardiography. The tumor was extirpated in total, histologic diagnosis was rhabdomyosarcoma, and the patient died after 6 months. CONCLUSION: Primary malignant cardiac tumors can simulate heart failure or systemic disorders. Cardiac rhabdomyosarcomas have a poor prognosis with the average survival of 6 months after the occurrence of symptoms and making a diagnosis. In cardiac insufficiency, differential diagnostics should be used to consider cardiac tumors that could be with certainty confirmed or excluded by echocardiography.     

髂骨原发囊样骨肿瘤及瘤样病变的影像学诊断

目的:分析髂骨囊样骨肿瘤及肿瘤样病变的影像学表现。方法:回顾性分析经穿刺或/和手术病理证实的46例髂骨囊样骨肿瘤及肿瘤样病变影像学表现。46例全部行X线片检查,38例行CT检查,20例行MRI检查(增强16例)。结果:46例中骨肿瘤29例,其中良性肿瘤12例(骨巨细胞瘤4例,内生软骨瘤、软骨母细胞瘤各2例,血管瘤、骨母细胞瘤、骨样骨瘤、软骨黏液样纤维瘤各1例),恶性肿瘤17例(恶性巨细胞瘤、骨恶性纤维组织细胞瘤各1例,软骨肉瘤、淋巴瘤各4例,骨肉瘤7例),肿瘤样病变17例(单纯性骨囊肿1例,邻关节骨囊肿、动脉瘤样骨囊肿、嗜酸性肉芽肿各2例,骨纤维异常增生症10例)。发病部位为髂翼39例,髋臼7例。病变主要表现为髂骨囊样骨质破坏,呈膨胀性改变30例,硬化环形成24例,病变内见钙化灶14例,软组织肿块20例。结论:常见的髂骨囊样骨肿瘤和肿瘤样病变一般都具有某些特征性的CT表现,必要时综合X线、MRI表现,可提高定性诊断符合率。