经胸超声心动图可用于无症状纵隔肿瘤的诊断

目的评价经胸超声心动图对纵隔肿瘤的诊断价值。方法回顾性分析2018年1月1日~2019年12月31日经胸超声心动图检查首次发现纵隔肿瘤的体检者临床资料，总结纵隔肿瘤在经胸超声心动图中的超声特点，并分别与放射影像（X线和CT扫描）及组织病理对比。结果共获得20例经胸超声心动图诊断纵隔肿瘤的无症状患者，检出纵隔肿瘤分为囊肿9例、胸腺肿瘤5例、淋巴结肿大3例、畸胎瘤2例、淋巴瘤1例。相较X线诊断而言，超声检查纵隔肿瘤有着较为明显的优势。此外，超声对纵隔肿瘤的检查价值也不亚于CT检查（Kappa=0.792，P＜0.001）。以病理检查结果为金标准，经胸超声心动图诊断纵隔肿瘤的误诊率为15%，对肿物良恶性质诊断的敏感性为75%，特异性为92%。结论经胸超声心动图检查可以用于纵隔肿瘤的诊断，不仅能对纵隔占位病变的内部结构进行观察，还可以对其良恶性质进行判定。 

Diagnosis of asymptomatic mediastinal masses by transthoracic echocardiography and its comparison with radiography and histopathology

ObjectiveTo evaluate the value of transthoracic echocardiography in the diagnosis of mediastinal tumors.MethodsThe clinical data of patients with mediastinal tumors detected by transthoracic echocardiography from January 1st, 2018 to December 31st, 2019 were analyzed retrospectively. The ultrasonic features of mediastinal tumors in transthoracic echocardiography were summarized and compared with radiographic images (X-ray and CT scan) and histopathology.ResultsTwenty asymptomatic patients with mediastinal tumors were diagnosed by transthoracic echocardiography.Mediastinal tumors were divided into cyst (n=9), thymic tumor (n=5), lymph node enlargement (n=3), teratoma (n=2) and lymphoma (n=1). Compared with X-ray diagnosis, ultrasonic examination of mediastinal tumors has obvious advantages. In addition, the value of ultrasound in the diagnosis of mediastinal tumors was no less than that of CT (Kappa=0.792, P < 0.001). Taking the results of pathological examination as the gold standard, the misdiagnosis rate of transthoracic echocardiography in the diagnosis of mediastinal tumors was 15%, and the sensitivity and specificity for the diagnosis of benign and malignant tumors were 75% and 92%, respectively.ConclusionTransthoracic echocardiography can be used in the diagnosis of mediastinal tumors. It can not only observe the internal structure of mediastinal space occupying lesions, but also judge the benign and malignant properties of mediastinal tumors.