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目的:探讨心内平滑肌瘤病(intracardiac leiomyomatosis,ICL)的临床和心脏超声的特点。方法:回顾性分析经手术和病理证实的9例ICL的临床和心脏超声表现。结果:9例中有7例曾因子宫肌瘤和(或)子宫静脉、宫旁静脉内平滑肌瘤病进行过手术治疗;7例有心脏相关的症状,5例为首发表现,3例为静脉梗阻症状,1例以盆腔包块为首发表现;胸闷、胸痛、呼吸困难、心悸、胸骨左缘3～5肋间收缩期杂音、腹胀、水肿和盆腔包块较为常见。影像学检查中,5例以心脏超声为最初的检查手段,主要表现为下腔静脉向右心腔内匍行延续的团块样或条索样肿物回声,随心动周期在心腔内摆动。结论:ICL具有特定的病史和心脏超声特点,大多数患者有心脏相关的症状;诊断的关键在于对该病的认识和警惕性;心脏超声在疾病的初筛、诊断、病情评估和治疗随访中有重要的作用。
Objective: To investigate the clinical and cardiac characteristics of intracardiac leiomyomatosis (ICL). Methods: Clinical and echocardiographic manifestations of 9 cases of ICL confirmed by surgery and pathology were retrospectively analyzed. RESULTS: Seven of the nine patients had surgery for uterine fibroids and / or uterine and paravapinal leiomyomata. Seven had heart-related symptoms, with five as the first manifestation and three as 1 case of pelvic mass as the first manifestation; chest tightness, chest pain, dyspnea, heart palpitations, intercostal systolic murmur 3 ~ 5 on the left sternal border, abdominal distension, edema and pelvic mass are more common. Imaging examination, 5 cases of cardiac ultrasound as the initial means of examination, the main performance of the inferior vena cava to the right of the intracranial continuous clumps of mass or cord-like mass echo, with cardiac cycle swing in the heart chamber. CONCLUSIONS: ICL has a specific medical history and characteristics of cardiac ultrasound. Most patients have heart-related symptoms. The key to diagnosis is awareness and vigilance of the disease. Echocardiography is used in the screening, diagnosis, assessment of disease and treatment follow-up Have an important role.