Oueslati Seddik, Saïd Wassim, Saaidi Imen, Djebbi Mourad, Charrada Leila, Rezgui Lamia, Najla Menif, Châabane Mounira
Service d'imagerie médicale, Hôpital Mahmoud Matri, Ariana, Tunisie.
Presse Med. 2006 Jul-Aug;35(7-8):1162-6. doi: 10.1016/s0755-4982(06)74773-x.
Early diagnosis of cardiac echinococcosis is required because this uncommon disease may lead to serious complications. We report 8 cases of cardiac hydatidosis, review the modes of diagnosis, and stress the contribution of modern imaging techniques.
This retrospective study describes 8 patients with cardiac echinococcosis. All had chest radiographs and thoracic computed tomography (CT). Transthoracic sonography was performed in 6 cases and magnetic resonance imaging (MRI) in 5.
Our patients ranged in age from 7 to 46 years, and the clinical features of their disease varied. Chest radiography showed the contours of the heart to be deformed in 3 cases and cardiomegaly in 3 others. Echocardiography revealed a homogeneous unilocular hydatid cyst in 5 cases. CT found homogeneous hypodense unilocular lesions in 7 cases, and a septated cyst with cardiac wall calcifications in one case. MRI showed round homogeneous lesions in 3 cases, all dark in T1-weighted sequences and bright in T2.
Clinical features vary substantially, and clinical latency is not uncommon. Chest radiography generally shows mediastinal masses. Transthoracic echocardiography can locate and count cardiac hydatid cysts and identify their borders. CT can simultaneously assess any visceral extension of the disease, while MRI provides details of mediastinal extensions.
Transthoracic echocardiography suggests the initial diagnosis. CT and MRI provide details of the location and extension of the cardiac hydatidosis.
由于这种罕见疾病可能导致严重并发症,因此需要对心脏包虫病进行早期诊断。我们报告8例心脏包虫病病例,回顾诊断方式,并强调现代成像技术的作用。
这项回顾性研究描述了8例心脏包虫病患者。所有患者均进行了胸部X线片和胸部计算机断层扫描(CT)检查。6例患者进行了经胸超声心动图检查,5例进行了磁共振成像(MRI)检查。
我们的患者年龄在7至46岁之间,疾病的临床特征各不相同。胸部X线片显示3例患者心脏轮廓变形,3例患者心脏扩大。超声心动图显示5例患者有均匀的单房性包虫囊肿。CT发现7例患者有均匀的低密度单房性病变,1例患者有带心脏壁钙化的分隔囊肿。MRI显示3例患者有圆形均匀病变,在T1加权序列中均为暗信号,在T2加权序列中为亮信号。
临床特征差异很大,临床潜伏期并不少见。胸部X线片通常显示纵隔肿块。经胸超声心动图可以定位和计数心脏包虫囊肿并确定其边界。CT可以同时评估疾病的任何内脏扩展情况,而MRI可以提供纵隔扩展的详细信息。
经胸超声心动图可提示初步诊断。CT和MRI可提供心脏包虫病的位置和扩展的详细信息。