The value of transthoracic echocardiography in the detection of extra-cardiac lesions

Abstract

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.

Imaging performance of thoracic SMARCA4-deficient undifferentiated tumor: a case report and literature review

“…In contrast, malignant thymic carcinoma often shows a hyperechoic occupancy with an unsmooth periphery, unclear border and uneven internal echoes. In addition, mediastinal lymphoma is often a well-defined hypoechoic mass with multiple fusions on US ( 36 , 37 ). Regarding the CEUS presentation of mediastinal tumors, Pan et al ( 38 ) found the specificity of CEUS was higher than that of contrast-enhanced MRI (CE-MRI), and the positive predictive value and diagnostic coincidence rate of CEUS were equal to those of CE-MRI, which means CEUS can be used as an effective alternative and complementary examination for patients who cannot undergo CE-MRI.…”