左心房黏液瘤引發之多發性腦部動脈瘤－病例報告

心臟原發性腫瘤中大多數為良性的心房黏液瘤（myxoma），以左心房較為常見，其次為右心房。由於脫落的腫瘤血栓與碎片會隨著血液循環方向移動，右心房黏液瘤常併發肺栓塞，而左心房黏液瘤常併發腦部血管栓塞，文獻上記載有極少的病例為併發腦部多發性動脈瘤。本次病例報告是一位22歲年輕女性，6年前因從事激烈運動，使左心房黏液瘤破裂，腫瘤血栓及碎片隨血流方向至腦部造成栓塞，當時經手術切除心臟黏液瘤及腦部栓塞之內科治療，治療後狀況良好。一個月前病患發生車禍，車禍後常自覺暈眩及沉重感因此前來就醫。臨床醫師安排了電腦斷層、磁振造影以及血管攝影等檢查，發現腦部遠端血管存在多顆動脈瘤。我們將針對黏液瘤合併多發性腦部動脈瘤在電腦斷層、磁振造影以及血管攝影的影像來做比較與討論。

關鍵字

左心房黏液瘤；腦部動脈瘤；磁振造影；血管攝影

並列摘要

The most common primary cardiac tumor is atrial myxoma, the majority are in the left atrium followed by the right atrium. Because of the thrombi or tumor fragments may travel with the bloodstream, right atrial myxomas are often complicated with pulmonary embolism and left atrial myxomas are often complicated with cerebral infarction. Multiple cerebral aneurysms caused by atrial myxoma are rare and have been reported. In this article, we reported a 22 year-old woman who had an episode of left atrial myxoma rupture caused by exercise six years ago. Cerebral infarction was noted and she received surgical resection of cardiac tumor and medical treatment for cerebral infarction at that time. Recently this patient presented with dizziness after a traffic accident one month ago. Multiple peripheral cerebral aneurysms were diagnosed by computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiogram (DSA). The image manifestations of multiple aneurysms were compared and discussed in this case report.

並列關鍵字

left atrial myxoma ； cerebral aneurysm ； magnetic resonance imaging (MRI) ； digital subtraction angiogram (DSA)

國際替代計量

左心房黏液瘤引發之多發性腦部動脈瘤－病例報告

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