Objective Transthoracic echocardiography (TTE) is generally recognized as the top choice for detecting myocardial and cardiac cavity lesions. Sonographers mostly focus on myocardium, cardiac cavity and cardiac hemodynamics, whereas the abnormal extra-cardiac lesions are easily remain unrecognized. The aim of this study was to investigate the ultrasonic image features in abnormal extra-cardiac lesions and the value of TTE in the detection of extra-cardiac lesions. Methods 49 cases of abnormal extra-cardiac lesion detected by TTE from January 2014 to December 2019 were collected, which were confirmed by surgical pathology. The two-dimensional ultrasonic characteristics and the relationships with the cardiac and great vessels were summarized on the basis of multi-view by TTE. All patients were also examined by computed tomography (CT). Results In 49 patients with abnormal extra-cardiac lesions, 37 malignant cases and 12 benign cases were included. There were 41 cases (41/49, 86.67%) of mediastinal lesions and 8 cases (8/49, 16.33%) of lung lesions. The maximum diameter ranged from 3.2 cm to 13.66 cm, and the median diameter was about 7.4 cm, among which 29 cases (29/49, 59.18%) were larger than 5 cm. 4 cases (4/49, 8.16%) of cystic anechoic lesions were pericardial cyst. 2 cases (2/49, 4.08%) of cystic-solid echogenic lesions were teratoma. The remaining 43 cases (43/49, 87.76%) presented as solid hypoechoic or heterogeneous masses. 6 cases compressed the heart and 21 cases encroached on the heart and vessels. Diagnosis coincidence rates of TTE and CT were respectively 77.55% and 93.88%, with a statistical difference (p = 0.012). Conclusion Although the diagnostic coincidence rate of TTE is slightly lower than that of CT, TTE has certain diagnostic value for extra-cardiac lesions.
BACKGROUND: There is lack of outcomes of transaortic shallow septal myectomy with mitral valve(MV) repair comparing with extended Morrow procedure in treatment of hypertrophic obstructive cardiomyopathy (HOCM) with severe interstitial fibrosis. OBJECTIVES: We report a 4-year single-center experience with transaortic shallow septal myectomy in combination with MV repair and compare it with extended Morrow surgery in a cohort of HOCM patients with severe interstitial fibrosis. METHODS: 36 patients who received surgery have been enrolled in current study. Their perioperative characteristics with echocardiographic results, myocardial histopathology and follow up outcomes had been graded and analyzed. We included two groups:13 patients who received shallow septal myectomy concomitant with mitral valvuloplasty (MVP) due to the intrinsic abnormalities of MV apparatus (Shallow septal myectomy + MVP group), and 23 patients who only received extended Morrow procedure without any intrinsic MV abnormalities (Extended Morrow group). RESULTS: Preoperative results revealed that left ventricular end-diastolic dimension (LVEDD) (46.9±1.41mm vs. 11.4±2.17mm, p<0.05), posterior wall thickness (PWT) (13.3±2.66mm vs. 11.4±2.17mm, p<0.05), left ventricular mass (LVM) (440.2±78.9g Vs. 310.9±127.6g, p<0.05), left ventricular mass index (LVMI) (231.7±75.39g/m2 Vs. 180.2±65.07g/m2, p<0.05 ) and late gadolinium enhancement (LGE) (72.73% Vs. 27.27%, p<0.01 ) had showed the significant difference between the two group. In the myocardial histopathological evaluation, more severe interstitial fibrosis of the resected myocardium in Shallow septal myectomy + MVP group had showed statistical significant difference compared with Extended Morrow group (p<0.05). Shallow septal myectomy + MVP procedure sufficiently release left ventricular outflow tract obstruction(LVOTO) and decrease mitral regurgitation (MR) with no increase of postoperative arrhythmia compared with Extended Morrow surgery. CONCLUSIONS: Shallow septal myectomy associated with concomitant MVP provided excellent results offering adequate treatment of LVOTO with no increase of postoperative arrhythmia complication for HOCM patients with severe interstitial fibrosis.
Background and AimsVulnerable plaques are closely related to ischemic stroke. To investigate the diagnostic value of multimodal plaque vulnerability ultrasound scoring system (PV‐USS) using histopathology as the gold standard.MethodsA total of 45 subjects who would be underwent carotid endarterectomy were recruited. The postoperative specimens were examined by histopathology. All responsible plaques were scanned dynamically in multiple sections by carotid ultrasound to measure maximum thickness and lumen stenotic degree, as well as, the echo, homogeneity, surface morphology, and echo type were observed. The above two‐dimensional (2D) ultrasonic features were systematically scored, that is, PV‐USS2D. Combined with contrast‐enhanced ultrasonography (CEUS), neovascularization grade in plaque was scored, which is PV‐USS2D+CEUS.ResultsAccording to the pathological results, 45 subjects were divided into vulnerable plaque group (27 cases, 60%) and non‐vulnerable plaque group (18 cases, 40%). PV‐USS2D and PV‐USS2D+CEUS in vulnerable plaque group were higher than those in non‐vulnerable plaque group (PV‐USS2D: 9.44 ± 2.10 vs 7.22 ± 1.73; PV‐USS2D+CEUS: 12.37 ± 2.10 vs 8.28 ± 1.81, P < .001). ROC curve analysis showed that the AUC of PV‐USS2D and PV‐USSCEUS was 0.783 and 0.929, respectively (P < .001). The best cutoff values of PV‐USS2D and PV‐USS2D+CEUS were, respectively, 9.5 (the maximum Youden index was 0.425, the sensitivity was 48.1%, the specificity was 94.4%) and 10.5 (the maximum Youden index was 0.667, the sensitivity was 77.8%, the specificity was 88.9%).ConclusionsUltrasound scoring system may be used as an effective method to evaluate the vulnerability of plaque. The diagnostic efficiency of PV‐USS2D+CEUS is more higher than PV‐USS2D.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.