Introduction
Materials and methods
Study participants
Echocardiographic image acquisition
CE protocol
Echocardiographic image analysis
Follow-up and validation
Statistical analysis
Results
Population characteristics
No cardiac mass (n = 2) and Pseudomass (n = 4) | Thrombus (n = 43) | Benign tumor (n = 66) | Malignant tumor (n = 30) | P value | |
---|---|---|---|---|---|
Age, mean (SD), years | 59.2 (13.6) | 54.6 (15.4) | 53.8 (11.5) | 64.3 (10.3) | 0.163 |
Sex (Male/Female) | 0.322 | ||||
Male | 4 | 23 | 46 | 17 | |
Female | 2 | 20 | 20 | 13 | |
Symptom | 0.993 | ||||
Asymptomatic | 1 | 7 | 12 | 5 | |
Dyspnea | 2 | 15 | 22 | 8 | |
Chest pain | 2 | 9 | 13 | 7 | |
Palpitations | 0 | 6 | 12 | 7 | |
Others | 1 | 6 | 7 | 3 | |
History of cardiovascular disease | 5 | 38 | 31 | 17 | < 0.001 |
History of malignant disease | 0 | 3 | 6 | 27 | < 0.001 |
Localization | 0.154 | ||||
Left ventricle | 3 | 10 | 8 | 5 | |
Left atrium | 1 | 15 | 26 | 4 | |
Right ventricle | 1 | 6 | 10 | 9 | |
Right atrium | 0 | 7 | 15 | 7 | |
Others | 1 | 5 | 7 | 5 |
Comparison and differentiation of cardiac tumors from thrombi
Thrombus (n = 43) | Tumor (n = 96) | P value | |
---|---|---|---|
Area, mean (SD), mm2 | 917.6 (386.7) | 1,513.2(794.2) | < 0.001 |
Echogenicity | 0.002 | ||
Uniform | 29 | 37 | |
Non-uniform | 14 | 59 | |
Boundary | 0.254 | ||
Well-demarcated | 31 | 59 | |
Not well-demarcated | 12 | 37 | |
Base | < 0.001 | ||
Narrow with peduncle | 0 | 32 | |
Narrow with notch | 39 | 23 | |
Broad | 4 | 41 | |
Mass perfusion | < 0.001 | ||
No perfusion | 27 | 0 | |
Mild perfusion | 11 | 54 | |
Intense Perfusion | 5 | 42 | |
Motility | 0.172 | ||
Absent | 33 | 62 | |
Present | 10 | 34 | |
Pericardial effusion | 0.438 | ||
Absent | 31 | 61 | |
Present | 12 | 35 | |
Enhancement A1/A2, | 0.39 | 1.20 | < 0.001 |
median (IQR) | (0.20–0.76) | (0.83–1.57) |
Sensitivity | Specificity | AUC | Accuracy | PPV | NPV | ||
---|---|---|---|---|---|---|---|
Thrombus/cardiac tumor | A1/A2 (Cutoff value = 0.499) | 0.979 (90.92-99.8%) | 0.884 (74.3-96.1%) | 0.977 (0.947-1.000) | 0.9568 (0.936–0.994) | 0.959 (0.943–0.981) | 0.951 (0.947-1.000) |
Malignant tumor/benign tumor | A1/A2 (Cutoff value = 1.583) | 0.933 (77.9-99.2%) | 0.939 (85.2-98.3%) | 0.950(0.894-1.000) | 0.9375 (0.921–0.984) | 0.875 (0.841–0.978) | 0.969 (0.962-1.000) |
Comparison and differentiation of malignant tumors from benign tumors
Benign tumor (n = 66) | Malignant tumor (n = 30) | P value | |
---|---|---|---|
Area, mean (SD), mm | 1,253.26 (659.25) | 1,812.43 (713.59) | < 0.001 |
Echogenicity | |||
Uniform | 34 | 3 | < 0.001 |
Non-uniform | 32 | 27 | |
Boundary | < 0.001 | ||
Well-demarcated | 49 | 10 | |
Not well-demarcated | 17 | 20 | |
Base | < 0.001 | ||
Narrow with peduncle | 28 | 4 | |
Narrow with notch | 20 | 3 | |
Broad | 18 | 23 | |
Mass perfusion | 0.045 | ||
Mild perfusion | 42 | 12 | |
Intense Perfusion | 24 | 18 | |
Motility | 0.011 | ||
Absent | 37 | 25 | |
Present | 29 | 5 | |
Pericardial effusion | 0.253 | ||
Absent | 39 | 22 | |
Present | 27 | 8 | |
Enhancement A1/A2, median (IQR) | 1.07 (0.64–1.17) | 1.48 (0.77–2.08) | < 0.001 |