Mansencal Nicolas, Revault-d'Allonnes Laure, Pelage Jean-Pierre, Farcot Jean-Christian, Lacombe Pascal, Dubourg Olivier
Pôle radiocardiovasculaire, centre de référence pour les maladies cardiaques heréditaires, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, université de Versailles-Saint-Quentin (UVSQ), Boulogne, France.
Arch Cardiovasc Dis. 2009 Mar;102(3):177-83. doi: 10.1016/j.acvd.2008.12.007. Epub 2009 Mar 6.
Conventional echocardiography is not a reliable method for characterizing tissue patterns of intracardiac masses.
To assess the ability of contrast echocardiography to characterize intracardiac masses.
Thirty-one consecutive patients with an intracardiac mass were included in this prospective study. All patients underwent conventional and contrast echocardiographic examinations. Analysis of characteristics by contrast agent allowed classification of intracardiac masses as follows: complete lack of enhancement, suggesting thrombus; partial and/or incomplete enhancement, suggesting myxoma; complete enhancement, suggesting intracardiac tumor. Tissue characteristics of intracardiac masses were also analyzed using at least one of the following techniques: cardiac magnetic resonance, pathology of intracardiac mass and/or mass resolved after anticoagulation during follow-up.
Using contrast echocardiography, an accurate diagnosis was made in all patients by an experienced investigator and in all patients except one (97%), by a physician trainee (p=0.31). Among patients with a history of tumor, echocardiography allowed accurate diagnosis of the nature of the mass in all patients; 50% of these patients presented with a secondary cardiac tumor and the others had a thrombus. Of the 14patients with a thrombus located in the left ventricle, 12 (86%) presented with left ventricular motion abnormalities using conventional echocardiography, whereas wall motion abnormalities were observed in all 14patients (100%) using contrast agent. In these patients, 91 and 99% of left ventricular segments were well visualized using conventional and contrast echocardiography, respectively (p<0.0001).
Contrast echocardiography may be useful for the tissue characterization of intracardiac masses.
传统超声心动图并非用于描述心内肿物组织特征的可靠方法。
评估超声造影心动图描述心内肿物的能力。
本前瞻性研究纳入了31例连续的心内肿物患者。所有患者均接受了传统及超声造影心动图检查。通过造影剂分析特征可将心内肿物分类如下：完全无增强提示血栓；部分和/或不完全增强提示黏液瘤；完全增强提示心内肿瘤。还使用以下至少一种技术分析了心内肿物的组织特征：心脏磁共振成像、心内肿物病理学检查和/或随访期间抗凝后肿物消失情况。
经验丰富的研究者使用超声造影心动图对所有患者均做出了准确诊断，而实习医生对除1例患者外的所有患者（97%）做出了准确诊断（p = 0.31）。在有肿瘤病史的患者中，超声心动图对所有患者肿物的性质均做出了准确诊断；其中50%的患者为继发性心脏肿瘤，其余患者为血栓。在14例左心室有血栓的患者中，12例（86%）使用传统超声心动图显示左心室运动异常，而使用造影剂时所有14例患者（100%）均观察到室壁运动异常。在这些患者中，使用传统和超声造影心动图分别有91%和99%的左心室节段显示良好（p<0.0001）。
超声造影心动图可能有助于心内肿物的组织特征描述。
