Abstract 1068: Evaluation of Malignant and Benign Cardiac Masses by Quantitative Real-Time Contrast Echocardiography

Abstract

Primary tumors of the heart are rare, most of them benign. However the differential diagnosis between benign and malignant tumors is very difficult. Quantitative Real-time Contrast Echocardiography(QRTCE) can evaluate the vascularity of cardiac masses and therefore help in characterizing the nature of cardiac masses. To evaluate the perfusion of cardiac masses and to compare the quantitative perfusion parameters of malignant and benign cardiac tumors by QRTCE. We studied 42 patients with cardiac masses, 23(54.8%) women, mean age 47.2±17.9 years old, 23(54.8%) with malignant tumor and 19 (45.2%) with benign tumors. Contrast-enhanced images were obtained after intravenous administration of PESDA(perfluorocarbon-exposed sonicated dextrose and albumin) or Definity®(lipid-encapsulated microbubbles) contrast. Q-lab software was applied to quantitative the perfusion of mass and adjacent cavity. The CE-derived rate of microbubble velocity(β), blood volume(A), blood flow(A × β) and relative blood flow(A/Acavity × β) were obtained by curve fitting of videointensity versus time plots, after the transient destruction of microbubbles by high-energy ultrasound. All malignant cardiac and 16 benign masses were confirmed by pathology. Blood velocity (β) was greater in the malignant than benign mass (1.4±2.04 × 0.71±0.48 dB, p=0.001). Malignant and benign mass A, A×B and A/Acavity × β values were 4.11±3.99 × 3.4±2.53, p=0.095; 3.69±3.95 × 2.85±3.36, p=0.113; 0.18±0.24 × 0.13±0.17, p=0.442; respectively. The malignant tumors were primary cardiac lymphoma (n=2), mediastinal lymphoma (n=5), pericardial mesothelioma(n=1) and metastatic tumors(n=15). Myxoma (n=15), lypoma(n=1), paraganglioma(1) and rabdomyoma(n=2) constituted the benign masses. QRTCE provides important information to differentiate the nature of cardiac masses by the demonstration of higher values of resting myocardial blood flow.