分析原发性非黏液性心脏肿瘤（PNCT）的临床、病理及超声心动图特点。

选取2005年1月至2021年6月在武汉亚洲心脏病医院心外科住院治疗的51例PNCT患者，所有患者均经术后病理结果证实。其中良性肿瘤35例，恶性肿瘤16例。对患者的临床表现、良性与恶性PNCT的超声心动图特征及手术病理资料做回顾性分析。

51例PNCT患者临床表现主要为胸闷气短23例，胸痛5例，呼吸困难8例，无明显临床症状16例；28例患者有不同程度的心律失常。51例患者，良性肿瘤（68.6%，35/51）比例高于恶性肿瘤（31.4%，16/51），良性PNCT患者中血管瘤（22.8%，8/35）、纤维瘤（17.1%，6/35）、脂肪瘤（17.1%，6/35）最常见，恶性肿瘤中肉瘤（62.5%，10/16）最多见，其次为淋巴瘤（37.5%，6/16）。在恶性肿瘤患者中，右心系统的发病比例最高为75.0％，与左心系统（12.5%）和心包（12.5%）发病比例相比，差异具有统计学意义（P＜0.05）；良性PNCT患者中各部位发病比例差异无统计学意义（P＞0.05）。良性与恶性PNCT的超声心动图特点比较，肿瘤形态、基底宽度、周围组织侵犯及心包积液比较差异具有统计学意义（P均＜0.05），内部回声、活动度大小、是否有瘤蒂及心腔内是否存在梗阻比较差异无统计学意义（P均＞0.05）。19例行心肌声学造影的患者中，心包囊肿、血囊肿为无强化，纤维瘤、横纹肌瘤及脂肪瘤为轻度强化，肉瘤及淋巴瘤表现为均匀或不均匀明显强化。

PNCT良性居多，恶性肿瘤以右心系统多见，临床表现缺乏特异性；超声心动图结合心肌声学造影可对肿瘤良恶性进行鉴别，肿瘤发病率、发生部位及超声心动图特点有助于肿瘤定性诊断。

To explore the clinical, pathological, and echocardiographic features of primary non-mucinous cardiac tumors (PNCTs).

The clinical manifestations, echocardiographic features, and surgical pathological data of 51 patients with PNCTs confirmed at Wuhan Asia Heart Hospital from January 2005 to June 2021 were analyzed retrospectively. According to pathological results, there were 35 cases of benign tumors and 16 cases of malignant tumors.

The clinical manifestations of 51 patients with PNCT were mainly chest tightness and shortness of breath in 23 cases, chest pain in 5, dyspnea in 8, syncope in 6, lower limb edema in 4, and no obvious clinical symptoms in 16 cases; 28 patients had different degrees of arrhythmia. Among the 51 patients included, the proportion of benign tumors (68.6%, 35/51) was higher than that of malignant tumors (31.4%, 16/51). Hemangioma (22.8%, 8/35), fibroma (17.1%, 6/35), and lipoma (17.1%, 6/35) were the most common in benign PNCT patients, while sarcoma (62.5%, 10/16) was the most common in malignant tumors, followed by lymphoma (37.5%, 6/16). Among the patients with malignant tumors, the right cardiac system had the highest incidence rate at 75.0%, which was statistically higher compared with the incidence rate in the left cardiac system (12.5%) and pericardium (12.5%) (P＜0.05). There was no statistically significant difference in the proportion of benign PNCT patients among different sites (P＞0.05). The echocardiographic characteristics of benign and malignant PNCTs were significantly different with regard to tumor shape, basal width, surrounding tissue invasion, and pericardial effusion (P＜0.05). Myocardial contrast echocardiography was assessed for 19 patients; pericardial cyst and blood cyst showed no enhancement, fibroma, rhabdomyoma, and lipoma showed mild enhancement, and sarcoma and lymphoma showed uniform or uneven enhancement.

PNCTs are mostly benign, malignant tumors more commonly occur in the right cardiac system, and the clinical manifestations are lack of specificity. Echocardiography and myocardial contrast echocardiography can differentiate malignant and benign tumors. The incidence rate, location, and echocardiographic characteristics of tumors are helpful to the qualitative diagnosis of PNCTs.