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一例术前通过重建CT诊断为支气管囊肿的病例,该CT显示心脏异常。

A case with bronchogenic cyst diagnosed by reconstruction CT prior to surgery which showed cardiac abnormalities.

作者信息

Fujita N, Tosaka M, Amemiya K, Suzuki S, Kasanuki H, Nakamura K, Kondo M, Hirosawa K, Koyanagi H, Kono A

出版信息

Heart Vessels. 1985 Feb;1(1):51-5. doi: 10.1007/BF02066488.

Abstract

A case report of a patient with bronchogenic cyst who presented with cardiogenic symptoms was described. The precise diagnosis was finally made after completing various diagnostic procedures which included reconstruction computed tomography. The patient, a 30-year-old man, was admitted to our hospital because of palpitation, chest pain and fever of three weeks duration. An electrocardiogram (ECG) revealed evidence suggestive of left atrial overloading and frequent atrial premature beats. A chest roentgenogram showed an abnormal shadow behind the right upper portion of the heart and a cross-sectional echocardiogram revealed abnormal echoes with ill-defined margins in the left atrium. Computed tomography (CT) revealed the presence of the left atrial tumor but left atriography suggested that it was extracardiac and compressing the left atrium. Reconstruction CT was therefore performed and the cyst was diagnosed as being in a subcarinal position. A mobile calcified mass was also demonstrated by the CT. An operation was performed and a cyst, 6 X 3 cm, was removed almost completely and a histopathological diagnosis of bronchogenic cyst was made. In this particular case, ECG abnormalities which suggest atrial damage and the diagnostic usefulness of reconstruction CT are stressed.

摘要

本文描述了一例表现为心源性症状的支气管囊肿患者的病例报告。在完成包括重建计算机断层扫描在内的各种诊断程序后,最终做出了准确诊断。该患者为一名30岁男性,因心悸、胸痛和持续三周的发热入住我院。心电图(ECG)显示有提示左心房负荷过重和频发房性早搏的证据。胸部X线片显示心脏右上部分后方有异常阴影,横断面超声心动图显示左心房内有边界不清的异常回声。计算机断层扫描(CT)显示左心房有肿瘤,但左心房造影提示肿瘤位于心外并压迫左心房。因此进行了重建CT检查,诊断囊肿位于隆突下位置。CT还显示了一个可移动的钙化肿块。进行了手术,切除了一个6×3厘米的囊肿,几乎完全切除,并做出了支气管囊肿的组织病理学诊断。在这个特殊病例中,强调了提示心房损害的心电图异常以及重建CT的诊断价值。

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