CAJ | 학술논문

目的：探讨心脏原发性血管肉瘤的CT、MRI表现，以提高对该病的影像诊断水平。方法：回顾性分析5例经临床病理证实的心脏原发血管肉瘤患者的临床及影像资料。5例中男4例，女1例；年龄24～45岁，平均34.5岁。对肿瘤的部位、大小、形态、边缘、CT密度、MRI信号及强化形式进行分析。5例中，3例行胸部CT平扫加增强扫描，2例行CT平扫、MRI平扫及增强扫描。结果：5例心脏原发性血管肉瘤均发生在右心房游离壁，向心腔内或外生长。CT平扫表现为等或稍低密度；MRI平扫T1WI表现为与心肌信号相似的等或稍低信号，T2WI表现为不均匀稍高信号；如瘤体内有坏死、出血、钙化，则表现为混杂密度或混杂信号。CT及MRI增强扫描肿瘤呈明显不均匀延迟强化，CT增强扫描瘤体内见肿瘤血管或血管团。结论：心脏原发血管肉瘤具有一定的影像特征，掌握这些特征有助于病变的诊断及鉴别诊断。
목적：탐토심장원발성혈관육류적CT、MRI표현，이제고대해병적영상진단수평。방법：회고성분석5례경림상병리증실적심장원발혈관육류환자적림상급영상자료。5례중남4례，녀1례；년령24～45세，평균34.5세。대종류적부위、대소、형태、변연、CT밀도、MRI신호급강화형식진행분석。5례중，3례행흉부CT평소가증강소묘，2례행CT평소、MRI평소급증강소묘。결과：5례심장원발성혈관육류균발생재우심방유리벽，향심강내혹외생장。CT평소표현위등혹초저밀도；MRI평소T1WI표현위여심기신호상사적등혹초저신호，T2WI표현위불균균초고신호；여류체내유배사、출혈、개화，칙표현위혼잡밀도혹혼잡신호。CT급MRI증강소묘종류정명현불균균연지강화，CT증강소묘류체내견종류혈관혹혈관단。결론：심장원발혈관육류구유일정적영상특정，장악저사특정유조우병변적진단급감별진단。
Objective:To explore the CT and MRI findings of primary cardiac angiosarcoma so as to improve the diagnostic ac-curacy of this rare cardiac tumor. Methods:CT and MRI findings of 5 patients (aged between 20 years to 50 years) with cardiac angiosarcoma proved by operation and pathology were analyzed retrospectively. One patient was female and the others male. Plain and enhanced chest CT scans were performed to 3 patients. Plain chest CT scans,plain and enhanced MRI scans were performed to the other 2 patients. The imaging findings including the tumor location,size,shape,rim,density or signal intensity and the enhancement pattern of the tumor were analyzed. Results:All of the 5 angiosarcomas were located in the right atrial-free wall protruding into the chamber or extruding external of the heart wall. The tumors presented as isodensity or slightly low density in plain CT scan,isointensity or slightly low intensity on T1WI MRI and heterogeneous high signal intensity on T2WI MRI. Heterogeneous density or signal intensity was seen in the tumors with necrosis,hemorrhage,or calcification. Obvious and delayed enhancement was noted after injection of contrast medium on CT and MRI images,and a tumor vessel or a mass of ir-regular,tortuous vessels was seen on enhanced CT images. Conclusion:The CT and MRI features of primary cardiac angiosarco-ma are specific,which are valuable in diagnosis and differential diagnosis.