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Detection of pericardial metastases by cross-section echocardiography
Insights
Cross-sectional echocardiography can detect pericardial metastases in patients with pericardial effusion. Echocardiography identified characteristic cauliflower-like masses in malignant cases, aiding diagnosis.
Area of Science:
- Cardiology
- Oncology
- Diagnostic Imaging
Background:
- Pericardial effusion is a common clinical finding with diverse etiologies.
- Malignant pericardial effusion can significantly impact patient prognosis.
- Accurate diagnosis of pericardial metastases is crucial for appropriate management.
Purpose of the Study:
- To evaluate the utility of cross-sectional echocardiography in detecting pericardial metastases.
- To identify characteristic echocardiographic features associated with malignant pericardial infiltration.
Main Methods:
- Cross-sectional echocardiography was performed on 69 patients diagnosed with pericardial effusion.
- Etiologies of effusion included malignant infiltration, chronic renal failure, postcardiac surgery, viral pericarditis, tuberculous pericarditis, and undetermined causes.
- Echocardiographic findings were correlated with surgical, autopsy, or clinical diagnoses.
Main Results:
- Nine patients had malignant infiltration; seven showed irregular, cauliflower-like masses protruding into the effusion space.
- These masses exhibited to-and-fro motion during ventricular systole.
- Patients with pericardial metastases displayed unique echocardiographic abnormalities not seen in other etiologies; adhesions presented differently.
Conclusions:
- Cross-sectional echocardiography is a valuable tool for detecting pericardial metastases.
- Characteristic echocardiographic findings, such as cauliflower-like masses with specific motion patterns, suggest malignant pericardial infiltration.
- Echocardiography can differentiate pericardial metastases from other causes of effusion and adhesions.
Abstract:
Cross-sectional echocardiography was performed on 69 patients with pericardial effusion. The etiology of the pericardial effusion was malignant infiltration of the pericardium in nine patients; chronic renal failure in 10; postcardiac surgery in 31; viral pericarditis in three; tuberculous pericarditis in two; and undetermined in 14. Seven of the nine patients with pericardial metastases were noted to have irregular cauliflower-like masses protruding from the pericardium and the epicardium into the echo-free space of the pericardial effusion. These masses demonstrated a to-and-fro motion within the pericardial space during ventricular systole. The presence of pericardial metastases was confirmed at operation in four cases and the three others had intrathoracic or colonic malignancy with widespread metastases. None of the patients without pericardial metastasis showed the characteristic abnormality seen in patients with pericardial metastases. Six patients had dense linear echoes connecting the pericardium and epicardium that probably represented adhesions (confirmation at surgery in one, and confirmation at autopsy in another), with an appearance that was different from that seen in pericardial metastases. We conclude that cross-sectional echocardiography may be useful for detecting pericardial metastases.