Extracardiac lesions detected on transthoracic echocardiography

Abstract

Extracardiac lesions are occasionally incidentally detected on transthoracic echocardiography (TTE), but such incidental detections have seldom been comprehensively investigated. Data collection and analysis for detected cases may lead to improved diagnostic capability. We retrospectively analyzed cases in which extracardiac lesions were detected during TTE performed by clinical laboratory technicians at our hospital from 2016 to 2021. Over the 5-year period, TTE was performed on a total of 31,930 patients, and extracardiac lesions were detected in 16 (0.05%) of these patients. The detected lesions were located in the liver (n = 6), gallbladder (n = 6), pancreas (n = 1), intra-abdominal lymph node (n = 2), and mammary gland (n = 1). Ten of the patients were found to have a malignancy. Fourteen of the 16 patients (including all 10 patients with malignancies) were examined by technicians who routinely also performed diagnostic imaging of the abdomen and superficial structures. The large number of detections in the liver and gallbladder was attributed to the fact that the inferior vena cava was assessed using epigastric as well as intercostal scanning. Our study findings suggest that multidisciplinary expertise and experience contribute to higher detection rates of extracardiac lesions. Furthermore, although most TTE-detected extracardiac lesions progressed by the time of detection, a small number of patients were able to receive appropriate treatment as a result of the incidental detection.