METHODS: Between April 2018 and July 2022, a prospective multicenter study was conducted, which included 145 consecutive patients suspected to have cardiac masses based on transthoracic echocardiography. All patients underwent CE examinations. The echocardiographic diagnosis relied on qualitative factors such as echogenicity, boundary, morphology of the base, mass perfusion, pericardial effusion, and motility as well as quantitative factors such as the area of the masses and the peak intensity ratio of the masses to adjacent myocardium (A1/A2).
RESULTS: The final confirmed diagnoses were as follows: 2 patients had no cardiac mass, 4 patients had pseudomass, 43 patients had thrombus, 66 patients had benign tumors, and 30 patients had malignant tumors. The receiver operating characteristic (ROC) analysis indicated that an optimal A1/A2 cutoff value of 0.499 distinguished a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.977, 97.9%, 90.7%, 95.9%, and 95.1%, respectively. The optimal A1/A2 cutoff value of 1.583 distinguished a cardiac tumor from a thrombus, with AUC, sensitivity, specificity, PPV, and NPV of 0.950, 93.3%, 93.9%, 87.5%, and 96.9%, respectively.
CONCLUSIONS: Combined with qualitative and quantitative analyses, CE has the potential to accurately differentiate among different types of cardiac masses.
方法:在2018年4月至2022年7月之间,进行了一项前瞻性多中心研究,其中包括根据经胸超声心动图连续怀疑有心脏肿块的145例患者。所有患者均接受CE检查。超声心动图诊断依赖于定性因素,如回声,边界,基底的形态,质量灌注,心包积液,和运动性以及定量因素,例如肿块的面积和肿块与相邻心肌的峰值强度比(A1/A2)。
结果:最终确诊为:2例患者无心脏质量,4个病人有假性肿块,43例患者有血栓,66例患者有良性肿瘤,30例患者有恶性肿瘤。接收器工作特性(ROC)分析表明,最佳A1/A2截止值为0.499可区分心脏肿瘤与血栓,AUC,灵敏度,特异性,PPV,净现值为0.977、97.9%,90.7%,95.9%,和95.1%,分别。最佳A1/A2截止值1.583区分心脏肿瘤和血栓,AUC,灵敏度,特异性,PPV,净现值为0.950,93.3%,93.9%,87.5%,96.9%,分别。
结论:结合定性和定量分析,CE具有准确区分不同类型的心脏质量的潜力。