Uso da ecocardiografia contrastada para avaliação de tumores e trombos

Uenishi, Eliza Kaori; Caldas, Márcia Azevedo; Saroute, Ally N. R.; Tsutsui, Jeane Mike; Piotto, Gustavo H. M.; Falcão, Sandra N.R.S.; Mathias, Wilson

doi:10.1590/s0066-782x2008001700015

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…Although transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE) are currently considered to be the best tools for evaluating cardiac valve tumor, TEE may be superior to TTE in the evaluation of small cardiac valve tumor (3). Meanwhile, contrast intracardiac echocardiography and positron emission tomography–computed tomography (PET–CT) play an important role in the differentiation of secondary cardiac valve tumor (7, 8).…”

Section: Discussionmentioning

confidence: 99%

Primary cardiac valve tumors: Retrospective analysis of 11 cases of surgical treatment

Li¹

2018

Anatol J Cardiol

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Objective: To explore the clinical features and surgical treatment experience of primary cardiac valve tumor. Methods: The present study retrospectively analyzed the clinical data of 11 patients with primary valvular tumors who underwent surgical treatment in our department from 1980 to 2016. Echocardiography of preoperative patients was indicated as a heart valve tumor. All patients underwent cardiopulmonary bypass surgery after endocardial angiography and positron emission tomography–computed tomography diagnosis, including four tumor resections–valvuloplasty and seven tumor resections–heart valve replacement. Pathological analysis was performed on all tumors. Postoperative cardiac ultrasound was followed up. Pathological analysis was performed on all tumors. All patients underwent postoperative ultrasound follow-up examination. Results: Primary valvular tumors are rare, accounting for only 0.034% (11/32.728) of extracorporeal circulation surgery in our center. It accounts for 2.8% (11/399) of primary cardiac tumors in the same period. Pathological study indicated that there were 10 cases of benign tumor and 1 case of low-grade sarcoma. After 0.6–16 years of follow-up, the operation effect was satisfactory. Conclusion: Most of these tumors are papillary fibroelastoma located on the mitral valve, and surgical operation is the best strategy for cardiac primary valve tumors.

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Section: Discussionmentioning

confidence: 99%

Primary cardiac valve tumors: Retrospective analysis of 11 cases of surgical treatment

Li¹

2018

Anatol J Cardiol

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“…Contrast echocardiography is highly sensitive (> 90%) for diagnosing intracardiac masses such as thrombi and tumors [46, 55]. Because a thrombus is an avascular collection of clotted blood; it will appear as a darkened area surrounded by contrast (Fig.…”

Section: Contrast Echocardiography (Ce)mentioning

confidence: 99%

“…3) [46]. On the other hand, both benign and malignant masses are vascular to some degree [55]. In addition, if contrast perfusion in a mass occurs quickly, the probability is higher that it is malignant rather than benign (e.g., mass refilling velocity of 10.5 s −1 vs. 0.9 s −1 for a secondary malignant tumor vs. a myxoma, respectively) [55].…”

Section: Contrast Echocardiography (Ce)mentioning

confidence: 99%

Recent technological advancements in cardiac ultrasound imaging

et al. 2018

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About 92.1 million Americans suffer from at least one type of cardiovascular disease. Worldwide, cardiovascular diseases are the number one cause of death (about 31% of all global deaths). Recent technological advancements in cardiac ultrasound imaging are expected to aid in the clinical diagnosis of many cardiovascular diseases. This article provides an overview of such recent technological advancements, specifically focusing on tissue Doppler imaging, strain imaging, contrast echocardiography, 3D echocardiography, point-of-care echocardiography, 3D volumetric flow assessments, and elastography. With these advancements ultrasound imaging is rapidly changing the domain of cardiac imaging. The advantages offered by ultrasound imaging include real-time imaging, imaging at patient bed-side, cost-effectiveness and ionizing-radiation-free imaging. Along with these advantages, the steps taken towards standardization of ultrasound based quantitative markers, reviewed here, will play a major role in addressing the healthcare burden associated with cardiovascular diseases.

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“…RTPE has been demonstrated to be a useful technique for the quantification of myocardial perfusion and determination of myocardial blood flow reserve [ 4 - 7 ]. Case reports and a single center study with a small sample of 16 patients have shown the possibility of evaluating vascularization of cardiac masses aiming to distinguish malignant from benign cardiac tumors, and also tumors from thrombi [ 8 - 14 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cardiac masses by real-time perfusion imaging echocardiography

Uenishi

Caldas

Tsutsui

et al. 2015

Cardiovasc Ultrasound

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BackgroundDiagnosis of cardiac masses is still challenging by echocardiography and distinguishing tumors from thrombi has important therapeutical implications. We sought to determine the diagnostic value of real-time perfusion echocardiography (RTPE) for cardiac masses characterization.MethodsWe prospectively studied 86 patients, 23 with malignant tumors (MT), 26 with benign tumors (BT), 33 with thrombi and 6 with pseudotumors who underwent RTPE. Mass perfusion was analyzed qualitatively and blood flow volume (A), blood flow velocity (β), and microvascular blood flow (A x β) were determined by quantitative RTPE.ResultsLogistic regression models showed that the probability of having a tumor increased by 15.8 times with a peripheral qualitative perfusion pattern, and 34.5 times with a central perfusion pattern, in comparison with the absence of perfusion. Using quantitative RTPE analysis, thrombi group had parameters of blood flow lower than tumor group. A values for thrombi, MT, and BT were 0.1 dB (0.01-0.22), 2.78 dB (1–7) and 2.58 dB (1.44-5), respectively; p < 0.05, while A x β values were 0.0 dB/s−1 (0.01–0.14), 2.00 dB/s−1 (1–6), and 1.18 dB/s−1 (0.52–3), respectively; p < 0.05. At peak dipyridamole stress, MT had greater microvascular blood volume than BT [A = 4.18 dB (2.14-7.93) versus A = 2.04 dB (1.09-3.55); p < 0.05], but no difference in blood flow [Axβ = 2.46 dB/s−1 (1.42–4.59) versus Axβ = 1.55 dB/s [1] (0.51-4.08); p = NS]. An A value >3.28 dB at peak dipyridamole stress predicted MT (AUC = 0.75) and conferred 5.8-times higher chance of being MT rather than BT.ConclusionRTPE demonstrated that cardiac tumors have greater microvascular blood volume and regional blood flow when compared with thrombi. Dipyridamole stress was useful in differentiating MT from BT.

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Uso da ecocardiografia contrastada para avaliação de tumores e trombos

Cited by 13 publications

References 12 publications

Primary cardiac valve tumors: Retrospective analysis of 11 cases of surgical treatment

Primary cardiac valve tumors: Retrospective analysis of 11 cases of surgical treatment

Recent technological advancements in cardiac ultrasound imaging

Evaluation of cardiac masses by real-time perfusion imaging echocardiography

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