Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milano, Italy.
Clin Radiol. 2013 Nov;68(11):e624-8. doi: 10.1016/j.crad.2013.06.010. Epub 2013 Aug 9.
To estimate the prevalence of cerebral aneurysms in patients previously treated for left cardiac myxoma (LCM).
This prospective institutional review board-approved study included patients treated for LCM. All patients treated at our institution (IRCCS Policlinico San Donato, Italy) were telephoned and those enrolled underwent unenhanced brain magnetic resonance imaging (MRI) using sagittal T1-weighted turbo spin-echo (TSE); axial T2-weighted TSE; axial fluid-attenuated inversion-recovery; axial echo-planar diffusion-weighted; and three-dimensional time-of-flight angiographic sequences.
Seventy-six patients were telephoned, and data regarding their clinical history since tumor resection were obtained for 49 patients (64%). Four of the 49 (8%) patients were deceased, one due to a cerebral hemorrhage from a ruptured cerebral aneurysm 8 years after tumor resection. One patient had a pacemaker preventing MRI. Of the remaining 44 patients, 31 refused MRI and 13 were enrolled (10 females; mean age 64 years). Three of the 13 (23%; two females; 59-78 years) were diagnosed with a cerebral aneurysm, from 2 mm to 4-5 mm in diameter, involving the right middle cerebral artery (n = 2) or the right internal carotid artery (n = 1). Including the deceased patient, the resulting prevalence was 4/14 (29%).
From this preliminary study, one-third of patients treated for LCM may present with a cerebral aneurysm. Longitudinal large studies are needed to further clarify this matter.
评估既往左心心脏黏液瘤（LCM）治疗患者中脑动脉瘤的患病率。
这项前瞻性机构审查委员会批准的研究纳入了接受 LCM 治疗的患者。我们机构（意大利圣多纳托综合医院）治疗的所有患者均通过电话联系，并对入选的患者进行矢状位 T1 加权涡轮自旋回波（TSE）、轴位 T2 加权 TSE、轴位液体衰减反转恢复、轴位回波平面扩散加权和三维时间飞跃血管造影序列的平扫脑磁共振成像（MRI）检查。
共电话联系了 76 名患者，其中 49 名（64%）患者提供了肿瘤切除后临床病史的相关数据。49 名患者中有 4 名（8%）死亡，1 例是因为肿瘤切除 8 年后破裂的脑动脉瘤导致的脑出血。1 例患者因装有起搏器而无法进行 MRI。在剩余的 44 名患者中，31 名拒绝 MRI，13 名接受了 MRI（10 名女性；平均年龄 64 岁）。13 名患者中有 3 名（23%；2 名女性；59-78 岁）被诊断患有脑动脉瘤，直径为 2-4-5mm，累及右侧大脑中动脉（n=2）或右侧颈内动脉（n=1）。包括死亡患者在内，患病率为 4/14（29%）。
从这项初步研究来看，三分之一接受 LCM 治疗的患者可能患有脑动脉瘤。需要进行长期的大型研究来进一步阐明这一问题。
