Xia Hongmei, Gan Ling, Jiang Yan, Tang Qi, Zhang Ping, Tang Xuefeng, Wen Li, Liu Zheng, Gao Yunhua
Department of Ultrasound, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Department of Ultrasound, Xinqiao Hospital, Third Military Medical University, Chongqing, China; Department of Ultrasound, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, China.
Int J Cardiol. 2017 Jun 1;236:466-472. doi: 10.1016/j.ijcard.2017.01.073. Epub 2017 Jan 9.
To determine whether the combination of transesophageal echocardiography (TEE) and contrast echocardiography (CE) accurately diagnose suspected cardiac masses using large sample data.
Patients with cardiac masses undergoing surgical treatment were enrolled in this study. Routine transthoracic echocardiography (TTE) and TEE examinations were carried out, and CE examinations were carried out when needed. All patients' clinical data and imaging features were retrospectively reviewed. Surgery and histopathology served as the gold standard for diagnosing cardiac masses.
A total of 252 consecutive patients were included in this study. Sixteen patients were lost to follow-up and were excluded from the study. The combinations of TEE and CE yielded the correct pathologic diagnosis in 225 of 230 patients (97.8%), while CT yielded the correct pathologic diagnosis in 122 of 141 patients (86.5%), p<0.01. TEE yielded the correct pathologic diagnosis in 219 of 226 patients (96.9%), and CE yielded the correct pathologic diagnosis in 45 of 48 patients (93.8%). TTE alone yielded the correct pathologic diagnosis in 163 of 236 patients (69.1%), p<0.001 for all. TEE imaging provided detailed and precise information regarding cardiovascular morphology, anatomy, hemodynamics and function, and CE provided information regarding tissue characteristics without subjecting patients to radiation exposure.
The combination of TEE and CE is feasible for the detection of suspected cardiac masses, especially in diagnosing and differentiating between benign and malignant lesions.
利用大样本数据确定经食管超声心动图（TEE）与对比增强超声心动图（CE）联合应用能否准确诊断疑似心脏肿物。
纳入接受手术治疗的心脏肿物患者。进行常规经胸超声心动图（TTE）和TEE检查，必要时进行CE检查。回顾性分析所有患者的临床资料和影像学特征。手术及组织病理学检查作为诊断心脏肿物的金标准。
本研究共纳入252例连续患者。16例患者失访，被排除在研究之外。TEE与CE联合应用在230例患者中的225例（97.8%）得出了正确的病理诊断，而CT在141例患者中的122例（86.5%）得出了正确的病理诊断，p<0.01。TEE在226例患者中的219例（96.9%）得出了正确的病理诊断，CE在48例患者中的45例（93.8%）得出了正确的病理诊断。单独TTE在236例患者中的163例（69.1%）得出了正确的病理诊断，总体p<0.001。TEE成像提供了有关心血管形态、解剖、血流动力学和功能的详细而精确的信息，CE提供了有关组织特征的信息，且不会使患者受到辐射暴露。
TEE与CE联合应用对于检测疑似心脏肿物是可行的，尤其在诊断和鉴别良恶性病变方面。
