Usefulness of contrast echocardiography for assessment of intracardiac masses.
BACKGROUND
Conventional echocardiography is not a reliable method for characterizing tissue patterns of intracardiac masses.


OBJECTIVE
To assess the ability of contrast echocardiography to characterize intracardiac masses.


METHODS
Thirty-one consecutive patients with an intracardiac mass were included in this prospective study. All patients underwent conventional and contrast echocardiographic examinations. Analysis of characteristics by contrast agent allowed classification of intracardiac masses as follows: complete lack of enhancement, suggesting thrombus; partial and/or incomplete enhancement, suggesting myxoma; complete enhancement, suggesting intracardiac tumor. Tissue characteristics of intracardiac masses were also analyzed using at least one of the following techniques: cardiac magnetic resonance, pathology of intracardiac mass and/or mass resolved after anticoagulation during follow-up.


RESULTS
Using contrast echocardiography, an accurate diagnosis was made in all patients by an experienced investigator and in all patients except one (97%), by a physician trainee (p=0.31). Among patients with a history of tumor, echocardiography allowed accurate diagnosis of the nature of the mass in all patients; 50% of these patients presented with a secondary cardiac tumor and the others had a thrombus. Of the 14patients with a thrombus located in the left ventricle, 12 (86%) presented with left ventricular motion abnormalities using conventional echocardiography, whereas wall motion abnormalities were observed in all 14patients (100%) using contrast agent. In these patients, 91 and 99% of left ventricular segments were well visualized using conventional and contrast echocardiography, respectively (p<0.0001).


CONCLUSIONS
Contrast echocardiography may be useful for the tissue characterization of intracardiac masses.
Pôle radiocardiovasculaire, centre de référence pour les maladies cardiaques heréditaires, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris, université de Versailles-Saint-Quentin (UVSQ), Boulogne, France. nicolas.mansencal@apr.aphp.fr
Nicolas
N
Mansencal
Laure
L
Revault-d'Allonnes
Jean-Pierre
JP
Pelage
Jean-Christian
JC
Farcot
Pascal
P
Lacombe
Olivier
O
Dubourg
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001706:Biopsy; D003287:Contrast Media; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006338:Heart Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D009200:Myocardial Contraction; D009232:Myxoma / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D000925:Anticoagulants; D003287:Contrast Media