Roudaut R, Le Guiffant C, Videau P, Clémenty J, Choussat A, Dallocchio M
Arch Mal Coeur Vaiss. 1980 Jul;73(7):775-84.
The diagnosis of atrial myxoma, the most common cardiac tumour, has been greatly facilitated by the introduction of echocardiography. The principal echocardiographic features and the diagnostic pitfalls encountered in a personal series of 7 atrial myxomas (5 left and 2 right) studied by M mode and 2-dimensional echocardiography are reported. In M mode, left atrial myxoma is a relatively easy diagnosis when the tumour prolapses into the mitral orifice. On standard mitro-aortic scanning, it is recorded behind the anterior mitral leaflet as a mass of abnormal echos appearing shortly after mitral valve opening. The diagnosis is much more difficult or even impossible in nonprolapsing tumours. Right atrial myxomas, prolapsing into the tricuspid orifice, do not usually pose any diagnotic problems. 2-dimensional echocardiography shows its superiority in the early diagnosis of small, localised, relatively immobile and non-prolapsing tumours. The parasternal (long axis and transverse views), the apical (4 and 2 chamber views) and subxiphoid positions were the most useful incidences and the tumour was visualised as a more or less circumscribed mass of echos. In all cases, 2-dimensional echo provided information on the size, mobility, insertion and the length of the pedicle of the tumour. Atrial myxoma is being recognised more easily and more often nowadays by echocardiography, the diagnostic method of choice, and 2-dimensional studies should be preferred.
超声心动图的应用极大地促进了最常见心脏肿瘤——心房黏液瘤的诊断。本文报告了通过M型和二维超声心动图研究的7例心房黏液瘤(5例左心房、2例右心房)的主要超声心动图特征及诊断陷阱。在M型超声心动图中,当肿瘤脱垂入二尖瓣口时,左心房黏液瘤相对容易诊断。在标准的二尖瓣 - 主动脉扫描中,它被记录在二尖瓣前叶后方,表现为二尖瓣开放后不久出现的异常回声团块。对于未脱垂的肿瘤,诊断则困难得多,甚至无法诊断。右心房黏液瘤脱垂入三尖瓣口时,通常不会造成诊断问题。二维超声心动图在早期诊断小的、局限性的、相对固定且未脱垂的肿瘤方面显示出优势。胸骨旁(长轴和短轴切面)、心尖(四腔心和两腔心切面)和剑突下切面是最有用的观察切面,肿瘤表现为或多或少边界清晰的回声团块。在所有病例中,二维超声心动图提供了有关肿瘤大小、活动度、附着部位和蒂长度的信息。如今,通过超声心动图这一首选诊断方法,心房黏液瘤更容易且更频繁地被识别,应优先进行二维超声心动图检查。