超声心动图对胎儿心脏横纹肌瘤的诊断及评价

目的探讨胎儿横纹肌瘤的超声诊断方法、技巧及病理特征.方法回顾性分析52例胎儿横纹肌瘤的病例资料,分析总结各诊断切面的肿物数目、位置、形态、大小、毗邻、界限、活动度以及形变等特征,分析肿物的病理特征,并总结该病的鉴别诊断.结果 52例病例资料均引产经病理证实为胎儿横纹肌瘤,该病多发常见,可位于各房、室腔,可附着于乳头肌、腱索、室间隔等结构.单发者常位于右心室,部分肿物可对心室及心房的流入道及流出道造成梗阻.肿物大多边界清楚,有包膜,部分边界模糊,与心肌界限不清.肿物大部分无活动度及形变,病理切片中均出现典型的＂蜘蛛＂细胞改变.结论胎儿超声心动图是诊断胎儿心脏横纹肌瘤的重要手段,是敏感发现、准确定位胎儿心脏横纹肌瘤的可靠方法,在诊断胎儿心脏横纹肌瘤中具有重要意义.

Echocardiographic Diagnosis of Fetal Cardiac Rhabdomyoma and Its Evaluation

Objective To investigate the ultrasonic diagnosis, skill and pathological characteristics of fetal rhabdomyoma of heart. Method Retrospective analysis was done on 52 cases of fetal rhabdomyoma. We analyzed and generalized the sections of diagnosis and characteristics of masses, including number, position, morphology, size, boarder, activity and deformation. Furthermore, pathological characteristics of the mass and differential diagnosis of this disease were summarized. Results All of 52 cases are confirmed to be fetal rhabdomyoma by the pathologic diagnosis,which should be a common disease,locate in the atria and ventricles of the heart, and adhere to papillary muscles, chordae tendineae and interventricular septum. It could be found that a singlerhabdomyoma was usually seen in right ventricle. Parts of mass tended to obstruct inflow and outflow tract of atria and ventricle. Most of the mass had clear boders and membranes, but no mobility or deformation. Some had obscure borders with cardiac muscle. Typical ＂spider changes＂ in cells could be found in all pathological slices. Conclusion Fetal echocardiography is a critical method for heart rhabdomyoma which is sensitive way to detect and exactly locate fetal rhabdomyoma of heart. Fetal echocardiography plays an important role in the diagnosis of fetal rhabdomyoma of heart.