Skip to main content
Top
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Computed Tomography | Research

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

Authors: Lei Yan, Qinyun Ruan, Chaoyang Qu, Chunyan Huang, Liyun Fu

Published in: BMC Surgery | Issue 1/2022

Login to get access

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.
Literature
1.
go back to reference McErlean A, Huang J, Zabor EC, Moskowitz CS, Ginsberg MS. Distinguishing benign thymic lesions from early-stage thymic malignancies on computed tomography. J Thorac Oncol. 2013;8:967–73.CrossRefPubMedCentralPubMed McErlean A, Huang J, Zabor EC, Moskowitz CS, Ginsberg MS. Distinguishing benign thymic lesions from early-stage thymic malignancies on computed tomography. J Thorac Oncol. 2013;8:967–73.CrossRefPubMedCentralPubMed
2.
go back to reference Rahmouni A, Divine M, Lepage E, et al. Mediastinal lymphoma: quantitative changes in gadolinium enhancement at MR imaging after treatment. Radiology. 2001;219:621–8.CrossRefPubMed Rahmouni A, Divine M, Lepage E, et al. Mediastinal lymphoma: quantitative changes in gadolinium enhancement at MR imaging after treatment. Radiology. 2001;219:621–8.CrossRefPubMed
3.
4.
go back to reference Larry N, Rachel S, Friedrich KD. Causes of death of patients with lung cancer. Arch Pathol Lab Med. 2012;136:1552–7.CrossRef Larry N, Rachel S, Friedrich KD. Causes of death of patients with lung cancer. Arch Pathol Lab Med. 2012;136:1552–7.CrossRef
5.
go back to reference Ultrasound techniques in the evaluation of the mediastinum. Part I: endoscopic ultrasound (EUS), endobronchial ultrasound (EBUS) and transcutaneous mediastinal ultrasound (TMUS), introduction into ultrasound techniques. J Thorac Dis. 2015;7:E311–25. Ultrasound techniques in the evaluation of the mediastinum. Part I: endoscopic ultrasound (EUS), endobronchial ultrasound (EBUS) and transcutaneous mediastinal ultrasound (TMUS), introduction into ultrasound techniques. J Thorac Dis. 2015;7:E311–25.
6.
go back to reference Wernecke K, Vassallo P, Peters PE, Potter R, Luckener HG. Diagnostic imaging of mediastinal tumors. Sensitivity and specificity of sonography in comparison with computed tomography and conventional x-ray diagnosis. Radiology. 1990;30:532–40. Wernecke K, Vassallo P, Peters PE, Potter R, Luckener HG. Diagnostic imaging of mediastinal tumors. Sensitivity and specificity of sonography in comparison with computed tomography and conventional x-ray diagnosis. Radiology. 1990;30:532–40.
7.
go back to reference Wernecke K, Vassallo P, Potter R, Luckener HG, Peters PE. Mediastinal tumors: sensitivity of detection with sonography compared with CT and radiography. Radiology. 1990;175:137–43.CrossRefPubMed Wernecke K, Vassallo P, Potter R, Luckener HG, Peters PE. Mediastinal tumors: sensitivity of detection with sonography compared with CT and radiography. Radiology. 1990;175:137–43.CrossRefPubMed
8.
go back to reference Wernecke K, Vassallo P, Peters PE, von Bassewitz DB. Mediastinal tumors: biopsy under US guidance. Radiology. 1989;172:473–6.CrossRefPubMed Wernecke K, Vassallo P, Peters PE, von Bassewitz DB. Mediastinal tumors: biopsy under US guidance. Radiology. 1989;172:473–6.CrossRefPubMed
9.
go back to reference Wernecke K. The examination technic and indications for mediastinal sonography. Rofo. 1989;150:501–8.CrossRefPubMed Wernecke K. The examination technic and indications for mediastinal sonography. Rofo. 1989;150:501–8.CrossRefPubMed
10.
go back to reference Wernecke K, Potter R, Peters PE, Koch P. Parasternal mediastinal sonography: sensitivity in the detection of anterior mediastinal and subcarinal tumors. AJR Am J Roentgenol. 1988;150:1021–6.CrossRefPubMed Wernecke K, Potter R, Peters PE, Koch P. Parasternal mediastinal sonography: sensitivity in the detection of anterior mediastinal and subcarinal tumors. AJR Am J Roentgenol. 1988;150:1021–6.CrossRefPubMed
11.
go back to reference Dietrich CF, Liesen M, Wehrmann T, Kirchner J, Caspary WF. Mediastinalsonographie, eine neue Bewertung der Befunde. Endokopieheute. 1995;4:278–94. Dietrich CF, Liesen M, Wehrmann T, Kirchner J, Caspary WF. Mediastinalsonographie, eine neue Bewertung der Befunde. Endokopieheute. 1995;4:278–94.
12.
go back to reference Dietrich CF, Liesen M, Buhl R, et al. Detection of normal mediastinallymph nodes by ultrasonography. Acta Radiol. 1997;38:965–9.CrossRefPubMed Dietrich CF, Liesen M, Buhl R, et al. Detection of normal mediastinallymph nodes by ultrasonography. Acta Radiol. 1997;38:965–9.CrossRefPubMed
13.
go back to reference Wright CD, Mathisen DJ. Mediastinal tumors: diagnosis and treatment. World J Surg. 2001;25:204–9.CrossRefPubMed Wright CD, Mathisen DJ. Mediastinal tumors: diagnosis and treatment. World J Surg. 2001;25:204–9.CrossRefPubMed
14.
go back to reference Paradies G, Zullino F, Orofino A, Leggio S. Mediastinal teratomas in children: case reports and review of the literature. Ann Ital Chir. 2013;84:395–403.PubMed Paradies G, Zullino F, Orofino A, Leggio S. Mediastinal teratomas in children: case reports and review of the literature. Ann Ital Chir. 2013;84:395–403.PubMed
15.
go back to reference Detterbeck FC, Zeeshan A. Thymoma: current diagnosis and treatment. Chin Med J (Engl). 2013;126:2186–91. Detterbeck FC, Zeeshan A. Thymoma: current diagnosis and treatment. Chin Med J (Engl). 2013;126:2186–91.
16.
go back to reference Cho JS, Huh U, Lee J, et al. Giant pericardial cyst with cardiac tamponade: a case report. Asian J Surg. 2021;44:794–5.CrossRefPubMed Cho JS, Huh U, Lee J, et al. Giant pericardial cyst with cardiac tamponade: a case report. Asian J Surg. 2021;44:794–5.CrossRefPubMed
17.
go back to reference Li X, Zhou ZX, Fang LG. A case of thoracic esophageal carcinoma diagnosed by transthoracic echocardiography. J Clin Ultrasound Med. 2011;13(003):191–191. Li X, Zhou ZX, Fang LG. A case of thoracic esophageal carcinoma diagnosed by transthoracic echocardiography. J Clin Ultrasound Med. 2011;13(003):191–191.
18.
go back to reference Zhou JH, Shan HB, Ou W, et al. Contrast-enhanced ultrasound improves the pathological outcomes of US-guided core needle biopsy that targets the viable area of anterior mediastinal masses. Biomed Res Int. 2018;2018:9825709.PubMedPubMedCentral Zhou JH, Shan HB, Ou W, et al. Contrast-enhanced ultrasound improves the pathological outcomes of US-guided core needle biopsy that targets the viable area of anterior mediastinal masses. Biomed Res Int. 2018;2018:9825709.PubMedPubMedCentral
19.
go back to reference Fu J, Yang W, Wang S, et al. Clinical value of contrast-enhanced ultrasound in improving diagnostic accuracy rate of transthoracic biopsy of anterior-medial mediastinal lesions. Chin J Cancer Res. 2016;28:617–25.CrossRefPubMedCentralPubMed Fu J, Yang W, Wang S, et al. Clinical value of contrast-enhanced ultrasound in improving diagnostic accuracy rate of transthoracic biopsy of anterior-medial mediastinal lesions. Chin J Cancer Res. 2016;28:617–25.CrossRefPubMedCentralPubMed
20.
go back to reference Rick T, Kleiter M, Schwendenwein I, Ludewig E, Reifinger M, Hittmair KM. Contrast-enhanced ultrasonography characteristics of intrathoracic mass lesions in 36 dogs and 24 cats. Vet Radiol Ultrasound. 2019;60:56–64.CrossRefPubMed Rick T, Kleiter M, Schwendenwein I, Ludewig E, Reifinger M, Hittmair KM. Contrast-enhanced ultrasonography characteristics of intrathoracic mass lesions in 36 dogs and 24 cats. Vet Radiol Ultrasound. 2019;60:56–64.CrossRefPubMed
21.
go back to reference Wang D, Zhang J, Liu Y, et al. Diagnostic value of transthoracic echocardiography combined with contrast-enhanced ultrasonography in mediastinal masses. J Ultrasound Med. 2019;38:415–22.CrossRefPubMed Wang D, Zhang J, Liu Y, et al. Diagnostic value of transthoracic echocardiography combined with contrast-enhanced ultrasonography in mediastinal masses. J Ultrasound Med. 2019;38:415–22.CrossRefPubMed
Metadata
Title
The value of transthoracic echocardiography in the detection of extra-cardiac lesions
Authors
Lei Yan
Qinyun Ruan
Chaoyang Qu
Chunyan Huang
Liyun Fu
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01519-w

Other articles of this Issue 1/2022

BMC Surgery 1/2022 Go to the issue