CAJ | 학술논문

目的探讨心脏超声造影鉴别心脏占位性病变性质的价值.方法对38例心脏占位性病变患者(其中28例有金标准诊断结果)行SonoVue超声造影检查,根据病变部位造影剂增强状况将其诊断为血栓、良性肿瘤或恶性肿瘤.心脏超声造影定量分析比较病变区域及毗邻心肌造影剂峰值强度.结果心脏超声造影目测半定量分析诊断血栓8例,良性肿瘤8例,恶性肿瘤12例,其中2例富血供的良性肿瘤(1例心脏副神经节瘤、1例心脏横纹肌瘤)误诊为恶性肿瘤,其余诊断与金标准一致.16例病变造影定量分析诊断良性肿瘤或血栓10例,恶性肿瘤6例,与目测半定量分析诊断结果一致,其中2例误诊病例同前.结论心脏超声造影目测半定量分析可通过心脏占位性病变内的造影剂增强状况准确判断病变血供状态,从而协助判断其性质.
목적 탐토심장초성조영감별심장점위성병변성질적개치.방법 대38례심장점위성병변환자(기중28례유금표준진단결과)행SonoVue초성조영검사,근거병변부위조영제증강상황장기진단위혈전、량성종류혹악성종류.심장초성조영정량분석비교병변구역급비린심기조영제봉치강도.결과 심장초성조영목측반정량분석진단혈전8례,량성종류8례,악성종류12례,기중2례부혈공적량성종류(1례심장부신경절류、1례심장횡문기류)오진위악성종류,기여진단여금표준일치.16례병변조영정량분석진단량성종류혹혈전10례,악성종류6례,여목측반정량분석진단결과일치,기중2례오진병례동전.결론 심장초성조영목측반정량분석가통과심장점위성병변내적조영제증강상황준학판단병변혈공상태,종이협조판단기성질.
Objective To assess the usefulness of contrast echocardiography in differential diagnosing space-occupying lesions of the heart.Methods Contrast echocardiography was assessed for 38 patients of space-occupying lesion of the heart (SOLH).Contrast enhancement of SOLH was assessed visually,comparing with that in the adjacent myocardium:significant contrast enhancement,intensity higher than or equal to the adjacent myocardium; mild or partial contrast enhancement,intensity lower than the adjacent myocardium,or no contrast enhancement.Respectively,malignant tumors,benign tumors,and thrombus were diagnosed.Twenty-eight patients among the 38 cases had gold standard diagnosis.The consistency between visual assessment diagnosis and gold standards were compared with Kappa statistic.Results Visual semi-quantitative diagnosis of contrast echocardiography:thrombus,benign tumors and malignant tumors were diagnosed for 8,8 and 12 cases,separately.Except two highly vascular benign tumors (1rhabdomyoma and 1 paraganglioma) were misdiagnosed as malignant tumors,the rest 26 cases matched gold standard diagnosis.Quantitative analysis of contrast echocardiography,16 cases were suitable for quantitative an alysis,10 cases were diagnosed as benign tumors or thrombus (quantitative analysis could not differentiate the two),the rest 6 cases were diagnosed as malignant tumors.Quantitative analysis got the same 2 misdiagnosis as visual semi-quantitative diagnosis.Kappa value on visual semi-quantitative diagnosis of contrast echocardiography comparing with gold standard diagnosis was 0.892.Conclusions The characteristics of vascularity of SOLH can be accurately determined by the contrast enhancement level in diseased region through visual semi-quantitative analysis with contrast echocardiography.Contrast echocardiography can be mainly used in SOLH except thrombus that has been clearly diagnosed,especially for patients with on going or fore-past malignancy in other organs.