儿童原发性心脏肿瘤的影像特征.

Objective To explore the imaging features of primary cardiac tumors detected by echocardiography, CT and MR in children, and to analyze the value of each examination and the clinical examination strategies. Methods The clinical, pathological and imaging data of the children with primary cardiac tumors confirmed by surgery and pathology from Jun 2008 to Feb 2022 in Children’s Hospital, Fudan University were analyzed retrospectively. Tumor size, location, motion, signal characteristics on different sequences, and pericardial involvement were evaluated on MR images. Results A total of 23 children (16 males and 7 females) were included. The age of onset ranged from 1 month to 13 years old, average on (54.45±58.57) months. While the onset age of rhabdomyomas was only (7.23±6.30) months. The clinical manifestations mainly included 6 cases of cardiac murmur, 3 cases of cardiac insufficiency, 3 cases of epilepsy, 2 cases of cerebral infarction, and 1 case of arrhythmia. Pathological results showed that there were 22 cases of benign tumors (9 cases of fibromas, 8 cases of myxomas, 4 cases of rhabdomyomas and 1 case of lipoma) and 1 case of malignant tumor (rhabdomyosarcoma). Echocardiography has a high diagnostic accuracy for myxoma. CT showed a case of malignant rhabdomyosarcoma with invasion of the pericardium and compression of the pulmonary artery and bronchus. MR showed that the fibroma had significantly late gadolinium enhancement. The signal of rhabdomyoma was equal on T1WI, and slightly increased on T2WI, perfusion and late gadolinium enhancement sequences. Myxoma had high signal on T2WI and late gadolinium enhancement. It had obvious motions in Cine sequence. The signal of lipoma on each sequence was consistent with that of fat tissue, and there was no high signal of perfusion and late gadolinium enhancement. Conclusion All types of primary cardiac tumors in children have imaging characteristics. MR has great advantages in diagnosing cardiac tumors. The clinical team needs to select the appropriate examination method according to the actual medical situation. [ABSTRACT FROM AUTHOR]