Case Report: Multi-Modality Imaging of a Right Atrial Pseudoaneurysm in a Patient With Breast Cancer.
Case Report: Multi-Modality Imaging of a Right Atrial Pseudoaneurysm in a Patient With Breast Cancer.
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病例报告：乳腺癌患者右心房假性动脉瘤的多模态成像
DOI：
10.3389/fcvm.2020.623580
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发表时间：
2020
影响因子：
3.6
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Zhong Y;Ma CY;Dai X;Wang G
当血管壁受伤并且渗漏的血液聚集在周围组织中时，就会发生心脏假性动脉瘤。它们是非常罕见的事件，破裂的风险很高，预后也很差。我们报告一例右心房假性动脉瘤病例，患者为一名 54 岁女性患者，被诊断患有乳腺癌和肺转移。患者接受了 5 次顺铂心包内输注和 9 个周期的全身化疗。由于该患者有碘禁忌，因此在化疗过程中进行了随访评估，并进行了非对比增强计算机断层扫描 (CT)。无造影剂 CT 和超声检查显示右心房附近有新月形病变，但无法确定其性质。钆对比心脏磁共振 (CMR) 成像作为替代增强成像方式提供了重要信息。通过结合CT、超声检查和CMR图像以及患者的病史，我们推断该病变为右心房假性动脉瘤。这种情况与转移肿瘤细胞的侵蚀或多周期化疗或心包穿刺术累积的心脏毒性有关。这个单一病例报告表明，对于疑似心包转移的患者，应将心脏破裂视为潜在的并发症。 CMR 成像是检测右心房破裂的绝佳工具。
Cardiac pseudoaneurysms occur when a blood vessel wall is injured and the leaking blood is collected in the surrounding tissue. They are very rare events and have a high risk of rupture and poor prognosis. We report a case of right atrial pseudoaneurysm in a 54-year-old female patient diagnosed with breast cancer and lung metastasis. The patient underwent five intrapericardial infusions of cisplatin and nine cycles of systemic chemotherapy. Non-contrast-enhanced computed tomography (CT) was performed at follow-up evaluation during the chemotherapeutic process as this patient was contraindicated to iodine. CT without contrast and ultrasonography showed a crescent-shaped lesion near the right atrium but its nature could not be determined. Cardiac magnetic resonance (CMR) imaging with gadolinium contrast provided important information as an alternative enhanced imaging modality. By combining CT, ultrasonography and CMR images with the medical history of the patient, we inferred that the lesion was a pseudoaneurysm in the right atrium. This condition was related to the erosion of metastasized tumor cells or the accumulated cardiac toxicity of multiple cycles of chemotherapy or pericardiocentesis. This single case report suggests that cardiac rupture should be considered as a potential complication in patients with suspected pericardial metastasis. CMR imaging is an excellent tool for the detection of right atrial rupture.
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影响因子：
3.8
作者：
Muehlberg F;Funk S;Zange L;von Knobelsdorff-Brenkenhoff F;Blaszczyk E;Schulz A;Ghani S;Reichardt A;Reichardt P;Schulz-Menger J
通讯作者：
Schulz-Menger J
心脏MRI：一种用于表征蒽环类诱导心肌重塑的翻译成像工具。
影响因子：
4.7
作者：
Nguyen KL;Hu P;Ennis DB;Shao J;Pham KA;Chen JJ
通讯作者：
Chen JJ
影响因子：
39.3
作者：
Marcus, Frank I.;McKenna, William J.;Zareba, Wojciech
通讯作者：
Zareba, Wojciech
影响因子：
1.6
作者：
Celik, Mehmet;Yilmaz, Yusuf;Zehir, Regaip
通讯作者：
Zehir, Regaip
影响因子：
2.4
作者：
Nagpal, Prashant;Saboo, Sachin S.;Steigner, Michael L.
通讯作者：
Steigner, Michael L.