Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
Echocardiography. 2020 Feb;37(2):231-238. doi: 10.1111/echo.14597. Epub 2020 Jan 31.
To assess the qualitative and quantitative characteristics of suspected cardiac masses by contrast-enhanced ultrasonography (CEUS) and to evaluate its usefulness.
Twenty-eight adult patients with suspected cardiac masses were selected for this study. All of them were examined by conventional transthoracic echocardiography (TTE) and CEUS. The location, attachment point, basement, morphology, size, boundary, internal echo, shape change, range of motion, length, area, effect on hemodynamics, and peak enhancement of the masses (A1), and adjacent normal myocardium (A2) were measured. Then, the A1 to A2 ratio was calculated and the above parameters were analyzed.
The benign lesions showed regular morphology and clear-boundary uniform enhancement of the contrast agent. Malignant lesions showed an irregular shape, unclear boundary with surrounding tissue, and uneven enhancement of the contrast agent. The normal myocardial perfusion intensity was the same; there was no enhancement inside a simple thrombus, and the A1 of the benign lesion was lower than that of the normal myocardium (mean value [dB] ± SD, 0.63 ± 0.42); the A2 of the malignant lesion was higher than that of the normal myocardium (mean value [dB] ± SD, 1.49 ± 0.09). The difference in the ratio of A1 to A2 between groups was statistically significant (P < .05).
Contrast-enhanced ultrasonography can assess the basic biological characteristics and properties of cardiac masses and has a high diagnostic accuracy for differentiation of a thrombus from a tumor or a benign tumor from a malignant tumor.
评估对比增强超声心动图(CEUS)对疑似心脏肿块的定性和定量特征,并评价其有用性。
选择 28 例疑似心脏肿块的成年患者进行本研究。所有患者均接受常规经胸超声心动图(TTE)和 CEUS 检查。测量肿块的位置、附着点、基底、形态、大小、边界、内部回声、形状变化、活动范围、长度、面积、对血流动力学的影响以及肿块(A1)和相邻正常心肌(A2)的峰值增强。然后计算 A1 与 A2 的比值,并对上述参数进行分析。
良性病变表现为形态规则、边界清晰、对比剂均匀增强。恶性病变表现为形态不规则、边界不清与周围组织相连、对比剂不均匀增强。正常心肌灌注强度相同;单纯血栓内无增强,良性病变的 A1 低于正常心肌(平均值 [dB]±SD,0.63±0.42);恶性病变的 A2 高于正常心肌(平均值 [dB]±SD,1.49±0.09)。组间 A1 与 A2 比值差异有统计学意义(P<.05)。
CEUS 可评估心脏肿块的基本生物学特征和性质,对血栓与肿瘤、良性肿瘤与恶性肿瘤的鉴别具有较高的诊断准确性。