CAJ | 학술논문

目的　分析原发性非黏液瘤性心脏心包肿瘤影像学特征，评估几种影像诊断方法的主要优势及其局限性。方法　搜集术前有完整的临床、X线平片及超声诊断资料并经手术病理证实的原发性非黏液瘤性心脏心包肿瘤30例, 其中接受MRI 检查者14例、电子束CT（EBCT） 10例。结果X线平片示异常17例，包括肺淤血5例、心缘不规则3例、“怪异形”3例、合并心包积液5例、钙化1例。超声心动图（UCG）诊断正确22例，其中腔内肿瘤11例全部诊断正确；心包肿瘤10例，诊断正确8例；壁在性肿瘤9例，诊断正确者仅3例。MRI和CT诊断均正确。结论　心脏肿瘤应采用影像学综合诊断。X线只用于初步检查；心腔或心包腔内的肿瘤应优先选择UCG; 壁在性肿瘤或腔外侵犯需结合MRI或（和）EBCT, MRI还能够对脂肪瘤、纤维瘤和心包囊肿伴出血等作出初步的组织学定性诊断。
목적　분석원발성비점액류성심장심포종류영상학특정，평고궤충영상진단방법적주요우세급기국한성。방법　수집술전유완정적림상、X선평편급초성진단자료병경수술병리증실적원발성비점액류성심장심포종류30례, 기중접수MRI 검사자14례、전자속CT（EBCT） 10례。 결과X선평편시이상17례，포괄폐어혈5례、심연불규칙3례、“괴이형”3례、합병심포적액5례、개화1례。초성심동도（UCG）진단정학22례，기중강내종류11례전부진단정학； 심포종류10례，진단정학8례；벽재성종류9례，진단정학자부3례。MRI화CT진단균정학。 결론　심장종류응채용영상학종합진단。X선지용우초보검사；심강혹심포강내적종류응우선선택UCG; 벽재성종류혹강외침범수결합MRI혹（화）EBCT, MRI환능구대지방류、섬유류화심포낭종반출혈등작출초보적조직학정성진단。
Objective　To determine the value of four noninvasive imaging techniques in the diagnosis of the cardiac and pericardial tumors. Methods　A total of 30 cases with cardiac and pericardial tumors were analyzed in the present study. X-ray plain film and UCG were performed in 30 patients, respectively. MRI was performed in 14 patients and EBCT in 10 patients. Surgical exploration and historic diagnosis were used for reference in all patients. Results　Abnormal X-ray films were found in 17 of 30 patients. UCG defined the tumors in 22 of 30 patients although it detected all tumors in our series. It was noted that intracardiac tumors were determined in all 11 patients, intrapericardial tumors in 8 of 10 patients, but intramural tumors in only three of 9 patients. Either MRI or UFCT correlated extremely well with exploratory anatomic findings. Conclusion　X-ray plain film will be of benefit to observation of heart and lung simultaneously. One or two-side irregular cardiac silhouettes were considered as a significant sign. Intracardiac tumor and intrapericardial tumors can be defined well with UCG, but there was some limitation in defining intramural myocardial tumors. MRI contributed important additional anatomic information regarding the tumor′s relationship to the normal cardiovascular structures and /or its extension to the adjacent vascular and mediastinal structures. Tissue characterization by MRI may identify the pathognomonic fatty appearance of a lipoma and little proton density of fibroma, as well as differentiate solitary cyst from cyst with bleeding. EBCT can complement MRI findings. It can identify calcified tissues and can provide with detailed information.