Yu Jin-Fen, Cui Hui, Ji Guo-Min, Li Shu-Qi, Huang Yong, Wang Ruo-Ning, Xiao Wen-Feng
Magnetic Resonance Room, Ji Nan Zhang Qiu District hospital of TCM, Shan Dong, 250200, China.
CT Diagnosis Room, Liao Cheng People's hospital, Shan Dong, 252000, China.
BMC Med Imaging. 2019 Feb 14;19(1):16. doi: 10.1186/s12880-019-0318-4.
To investigate the CT manifestations of primary cardiac angiosarcoma.
The clinical and CT data for 9 patients with cardiac angiosarcoma were retrospectively analyzed.
The lesions in all nine cases were located in the right atrium. In two cases, the involved lesion led downward to the tricuspid valve and right ventricle, and the dynamic cine showed that the lesion affected the opening and closing of the tricuspid valve. In three cases, the lesion involvement led to a thickened pericardium, accompanied by pericardial effusions. On CT plain scans, six patients showed homogeneous density, while three showed inhomogeneous density, two of which were associated with bleeding. On enhanced CT scans, seven patients showed heterogeneous centripetal enhancement, and some angiograms showed lesions with tortuous small blood vessels. The remaining two cases showed early stage rapid inhomogeneous enhancement. Five cases showed multiple metastatic nodules in the lungs at the time of initial diagnosis; four of these showed distinct sharp edges in multiple pulmonary nodules.
Cardiac angiosarcoma has a predilection site and is prone to invading adjacent structures, manifesting as malignant pericardial and pleural effusions. The CT enhancement manifestations are mostly inhomogeneous and centripetal with ground-glass opacity peripheral to the intrapulmonary metastases.
探讨原发性心脏血管肉瘤的CT表现。
回顾性分析9例心脏血管肉瘤患者的临床及CT资料。
9例病变均位于右心房。2例病变向下累及三尖瓣及右心室，动态电影显示病变影响三尖瓣开闭。3例病变累及导致心包增厚，伴有心包积液。CT平扫6例密度均匀，3例密度不均匀，其中2例合并出血。CT增强扫描7例呈不均匀向心性强化，部分血管造影显示病变内有扭曲小血管。其余2例呈早期快速不均匀强化。5例初诊时肺部见多发转移结节；其中4例多发肺结节边缘清晰。
心脏血管肉瘤有好发部位，易侵犯相邻结构，表现为恶性心包及胸腔积液。CT增强表现多不均匀、向心性，肺内转移灶周边有磨玻璃样密度影。
