Preoperative two- and three-dimensional transesophageal echocardiographic assessment of heart tumors.
BACKGROUND
Two-dimensional transesophageal echocardiography is the most widely used diagnostic approach in the rare entity of heart tumors. The aim of this study was to assess the diagnostic usefulness of three-dimensional echocardiography in comparison with the two-dimensional technique in a rare clinical setting.


METHODS
Twenty-seven patients (18 women; mean age, 49.7 +/- 14 years) with a histologically proven diagnosis of a cardiac tumor were studied. The primary diagnosis was done by a two-dimensional transthoracic echocardiography (n = 9) and transesophageal echocardiography (n = 18). In addition, we performed three-dimensional transesophageal assessment in 5 patients with left atrial myxomas. The echocardiographic findings were compared with the intraoperative appearance and pathologic diagnosis.


RESULTS
The echocardiographically suspected diagnosis of a heart tumor in 29 cases was histologically correct in 27 patients (myxomas, 20; epicardial lipoma, 1; malignant epicardial mesothelioma, 1; metastatic processes of hypernephromas, 2; and undifferentiated tumors of the pericardium, 3). Only the combination of multiplane transesophageal and three-dimensional echocardiography was able to demonstrate the shape, dimensions, location, origin, surface, three-dimensional movement, and involvement of valves and was most useful in the preoperative diagnosis and planning.


CONCLUSIONS
Three-dimensional transesophageal echocardiography yields important additional clinical information and improves the operative planning. Three-dimensional echocardiography may become the best approach to study the anatomy and pathology of the heart as it provides an objective display of cardiac size and shape in heart tumors.
Borges
A C
AC
Medical Department I, Charité, Humboldt-University Berlin, Germany.
Witt
C
C
Bartel
T
T
Müller
S
S
Konertz
W
W
Baumann
G
G
D000328:Adult; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006338:Heart Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000000981:diagnostic imaging*; D011300:Preoperative Care / Q000379:methods*