肿瘤患者中心静脉导管相关右心房血栓形成：心血管磁共振研究病例系列
Central venous catheter-related right atrial thrombus in oncology patients: a case series of cardiovascular magnetic resonance studies.
作者信息
Cardoso Isabel, de Almeida José, Tsoumani Zoi, Alpendurada Francisco, Mohiaddin Raad H
机构信息
Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.
National Heart and Lung Institute, Imperial College London, London, UK.
出版信息
Eur Heart J Case Rep. 2024 Jun 28;8(7):ytae296. doi: 10.1093/ehjcr/ytae296. eCollection 2024 Jul.
BACKGROUND
Patients with cancer are at an increased risk of thrombus formation, often identified on routine echocardiogram in the right atrium. The 2022 ESC Guidelines on Cardio-oncology emphasize cardiac magnetic resonance (CMR) as the gold standard for thrombus identification.
CASE SUMMARY
We present a case series of seven patients who underwent CMR due to right atrial mass suspected to result from central venous catheter-related right atrial thrombus. In all cases, CMR enabled accurate diagnosis of a thrombus. It also allowed to assess complete or partial resolution of the thrombi following anticoagulation on follow-up studies.
DISCUSSION
The presence of a central venous catheter is recognized as a risk factor for thrombus formation, particularly when inappropriately advanced into the right atrium. The integration of CMR into the diagnostic pathway enabled precise thrombus identification and guidance for treatment in this population with a complex balance between cancer-related thrombotic and haemorrhagic risks.
背景
癌症患者血栓形成风险增加，常在常规超声心动图检查时发现右心房血栓。2022年欧洲心脏病学会（ESC）心脏肿瘤学指南强调心脏磁共振成像（CMR）是血栓识别的金标准。
病例总结
我们报告了一组7例患者的病例系列，这些患者因怀疑中心静脉导管相关右心房血栓导致右心房肿块而接受CMR检查。在所有病例中，CMR均能准确诊断血栓。它还能在随访研究中评估抗凝治疗后血栓的完全或部分溶解情况。
讨论
中心静脉导管的存在被认为是血栓形成的危险因素，尤其是当导管不当深入右心房时。将CMR纳入诊断流程能够在这个癌症相关血栓形成和出血风险复杂平衡的人群中实现精确的血栓识别和治疗指导。
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