Wang Jiang, Wang Gang, Bi Xiao, Zhang Ran, Liu Changfu
Department of Pulmonary & Critical Care Medicine, General Hospital of Chinese People's Liberation Army, 28th Fuxing Road, Beijing, 100853, China.
Department of Cardiology, Anshan Central Hospital, 77th Zhonghua Road (South), Anshan, 114001, Liaoning Province, China.
BMC Cardiovasc Disord. 2018 Nov 7;18(1):210. doi: 10.1186/s12872-018-0925-y.
The crista terminalis is a variation of normal anatomical structure within the right atrium which may be misdiagnosed with an abnormal atrial mass normally visualized in the standard views on the transthoracic echocardiogram.
In this case presentation, we demonstrated a rare case report describing the accidental discovery of a right atrial mass-like structure in a 54-year old Asian man without physical discomfort during an echocardiographic examination. These findings naturally caused some concern as the differential diagnosis such as right atrial myxoma or thrombus and further examination were organized. The subsequent positron emission tomography/magnetic resonance imaging (PET/MRI) differentiated a true right atrial mass from a strip extending into the atrium in accordance with prominent crista terminalis.
A preferable understanding of the complex anatomy and PET/MRI appearance of a prominent crista terminalis will minimize the misdiagnosis of this structure and avoiding unnecessary anxiety and more invasive examinations.
界嵴是右心房内正常解剖结构的一种变异，在经胸超声心动图的标准视图中，它可能被误诊为异常的心房肿物。
在本病例报告中，我们展示了一例罕见病例，描述了一名54岁无症状亚洲男性在超声心动图检查中意外发现右心房肿物样结构。这些发现自然引起了一些担忧，因此进行了诸如右心房黏液瘤或血栓等鉴别诊断并安排了进一步检查。随后的正电子发射断层扫描/磁共振成像（PET/MRI）根据突出的界嵴将真正的右心房肿物与延伸至心房的条索区分开来。
对突出界嵴的复杂解剖结构和PET/MRI表现有更好的了解，将最大限度地减少对该结构的误诊，并避免不必要的焦虑和更具侵入性的检查。
