USEFULNESS OF CONTRAST PERFUSION ECHOCARDIOGRAPHY FOR DIFFERENTIAL DIAGNOSIS OF CARDIAC MASSES
USEFULNESS OF CONTRAST PERFUSION ECHOCARDIOGRAPHY FOR DIFFERENTIAL DIAGNOSIS OF CARDIAC MASSES
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DOI：
10.1016/j.ultrasmedbio.2015.05.010
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发表时间：
2015-09-01
影响因子：
2.9
通讯作者：
Deng, You-Bin
中科院分区：
文献类型：
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作者：
Tang, Qiao-Ying;Guo, Ling-Dan;Deng, You-Bin
本研究的目的是评估对比灌注超声心动图在不同类型心脏肿块鉴别诊断中的作用。对72例心脏肿块患者进行常规超声心动图和声学造影灌注超声心动图检查。通过目视检查和定量时间-信号强度曲线分析确定注射造影剂后肿块和邻近心肌节段的对比增强程度。计算肿块和相邻心肌之间最大稳态像素强度的差异（Δ A（肿块-心肌））。所有肿块均经病理诊断或抗凝治疗后消退。16个肉眼未见强化的心脏肿块均证实为心脏血栓。24个肉眼检查不完全增强的肿块被确认为良性肿瘤。32个完全增强的心脏肿块中，30个经验证方法证实为恶性肿瘤，2个为良性肿瘤。Delta A（肿块-心肌）鉴别血栓与肿瘤的敏感性和特异性分别为93%和100%，鉴别良恶性肿瘤和血栓的敏感性和特异性分别为100%和97%。在对比灌注超声心动图期间，对心脏肿块相对于邻近心肌的增强程度进行视觉和定量评估，对于区分血栓与肿瘤或良性肿瘤与恶性肿瘤具有较高的诊断准确性。(C)2015年世界医学和生物学超声联合会。
The aim of this study was to assess the usefulness of contrast perfusion echocardiography in the differential diagnosis of different types of cardiac masses. Conventional echocardiography and contrast perfusion echocardiography were performed in 72 patients with cardiac masses. The degree of contrast enhancement of the mass and an adjacent section of myocardium after injection of contrast agent was determined by visual inspection and quantitative time-signal intensity curve analysis. The difference in maximal steady-state pixel intensity between the mass and the adjacent myocardium (Delta A(mass-myocardium)) was calculated. All masses had a pathologic diagnosis or resolved after anticoagulation. All 16 cardiac masses without enhancement on visual inspection were confirmed to be cardiac thrombi. Twenty-four masses with incomplete enhancement on visual inspection were recognized as benign tumors with validation methods. Of the 32 cardiac masses with complete enhancement, 30 were confirmed as malignant tumors and two as benign tumors with validation methods. The sensitivity and specificity of Delta A(mass-myocardium) in differentiating thrombi from tumors were 93% and 100%, respectively, and 100% and 97% in differentiating malignant tumors from benign tumors and thrombi. Both visual and quantitative assessment of degree of enhancement of cardiac masses in relation to the adjacent myocardium during contrast perfusion echocardiography had high diagnostic accuracy for differentiation of a thrombus from a tumor or a benign tumor from a malignant tumor. (C) 2015 World Federation for Ultrasound in Medicine & Biology.