The Use of Two-Dimensional Echocardiography for the Detection of Intracardiac Masses and Tumors

Abstract

Since the first intraatrial tumor was diagnosed by ultrasound in 1959, there has been vast experience with the use of echocardiography to detect cardiac tumors [1]. This large experience, using primarily M-mode echocardiography, has shown echocardiography to be a very reliable method for the diagnosis of intracardiac tumors. The most common intracardiac tumor, a left atrial myxoma, is easily recognized on M-mode echocardiography by the now very familiar pattern of dense echoes trailing behind the opening mitral valve in diastole and filling the left atrium in systole. Large tumors of other chambers of the heart are much rarer, but experience has shown that M-mode echocardiography can detect these tumors as well. The main limitation of M-mode echocardiography in the detection of cardiac tumors arises in those unusual patients with tumors in the right heart chambers, pulmonary artery, superior vena cava and extra-cardiac areas where imaging is often difficult. Two-dimensional echocardiography has overcome most of the problems by affording larger scan areas, more acoustic windows and most importantly the ability to present this information in a dynamic, moving format. This enhanced spatial resolution and the ability to perceive motion or the lack of it by two-dimensional echocardiography has recently allowed echocardiographers to detect left ventricular thrombi. Today with proper techniques, two-dimensional echocardiography can accurately diagnose and convincingly demonstrate most intra-and extra-cardiac masses. It is probably the diagnostic procedure of choice for the detection of masses.