作为肺栓塞的罕见来源的右前庭尾血栓:多模式成像和临床影响
Loay Ahmed Khair1, Samah M Ali1, Ibrahim M Alyazidi2
1Internal Medicine, Cardiology Unit, Security Forces Hospital, Makkah, SAU.
Cureus
|October 30, 2025
概括
右心房附属体血栓,肺栓塞的罕见原因,使用先进的成像诊断. 在这种情况下,迅速的抗凝药和抗生素可以解决血栓和症状.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 右心房附属体 (RAA) 血栓是肺栓塞 (PE) 的一个未被认可的原因.
- 雷亚血栓栓塞可以导致严重的栓塞并发症.
- 多模式成像对于诊断和管理至关重要.
研究的目的:
- 要强调怀疑RAA血栓在不明原因的PE中的重要性.
- 为了证明多模式成像在诊断和监测RAA血栓中的实用性.
- 在感染和抗脂抗体的背景下讨论RAA血栓的管理.
主要方法:
- 一个32岁的男性发烧,咳,体重减轻.
- 与对比度增强的胸部CT显示了肺栓塞.
- 经食道心声学 (TEE) 确定了RAA血栓.
- 心脏磁共振成像 (CMR) 证实了血栓并评估了回归.
- 实验室测试显示狼抗凝剂和阳性Brucella melitensis血清学.
主要成果:
- 在CT上检测到双边肺栓塞.
- 测试显示了一个大,移动的RAA血栓.
- CMR证实了血栓,并证明了抗凝剂的显著回归.
- 患者有阳性狼抗凝剂和高布鲁塞拉标位.
- 症状通过肝素,华法林和抗生素得到缓解.
结论:
- 在患有不明原因的PE的患者中,应该怀疑RAA血栓,特别是如果跨胸腔心声扫描正常.
- 多模式成像 (TEE,CMR) 对于诊断和随访至关重要.
- 血栓塞和狼抗凝剂可能会导致前血栓状况.
- 在这种情况下,抗凝药对RAA血栓解决有效.
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