Cardiac magnetic resonance imaging of primary cardiac tumors

Li, Xiaodan; Chen, Yan; Liu, Jiayi; Xu, Lei; Liu, Yu; Liu, Dongting; Sun, Zhonghua; Wen, Zhaoying

doi:10.21037/qims.2019.11.13

Cited by 37 publications

(40 citation statements)

References 50 publications

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“…Consequently, cardiac MRI is recommended as the standard technique for the assessment of cardiac tumors [ 20 ]. In our study, the lesions of four patients who underwent MRI examination all showed heterogeneous intensity, with hyperintense hemorrhage foci (known as cauliflower-like appearance) on both T1- and T2-weighted images compared with the myocardium, whereas their corresponding unenhanced CT scans showed no sign of hemorrhage, which is in line with the findings of previous studies [ 21 , 22 ]. The lesion of case 4 ( Figure 2 ) presented as irregular pattern on CT scan but was almost round with clear boundary on MRI images.…”

Section: Discussionsupporting

confidence: 91%

Clinical and Imaging Features of Primary Cardiac Angiosarcoma

et al. 2020

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This study aims to explore computed tomography (CT) and magnetic resonance imaging (MRI) features of patients diagnosed with primary cardiac angiosarcoma. The study involved the analysis of 12 patients diagnosed with primary cardiac angiosarcoma who underwent non-contrast (8/12) or contrast-enhanced CT (10/12) or MRI (4/12). Imaging appearances, including the tumor location and adjacent infiltration, were analyzed. All 12 lesions were located in the right atrium with a broad base. Adjacent invasion including the tricuspid valve and right ventricle (2/12), inferior or superior vena cava (2/12), pericardium (10/12), and right coronary artery (7/12) was common. On unenhanced CT scans, tumors in two patients were homogeneous in density, whereas the others were inhomogeneous. Ten patients showed heterogeneous enhancement. The enhancement pattern showed no direct correlation with the differentiation degree of the tumor. Four lesions manifested as heterogeneous intensity, with hyperintense hemorrhage foci on both T1- and T2-weighted MRI. Three showed rim enhancement and one showed patchy enhancement. Primary cardiac angiosarcoma often involves the right side of the heart with infiltration of peripheral structures. CT features include typical inhomogeneous density on unenhanced scans and heterogeneous centripetal enhancement on enhanced scans. A cauliflower-like appearance on both T1- and T2-weighted MRI is common. The characteristic enhancement pattern of MRI remains to be determined.

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Section: Discussionsupporting

confidence: 91%

Clinical and Imaging Features of Primary Cardiac Angiosarcoma

et al. 2020

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“…(The common tumors of pericardium are shown in Supplementary Table 1 ). The clinical manifestations of pericardial angiosarcoma include (i) repeated medium to large amounts of hemorrhagic pericardial effusion; (ii) one or more irregular masses extending along the pericardium, surrounding or compressing the heart ( 4 ); (iii) and thickened pericardium, which can appear as a linear contrast enhancement on CMR with radiation from the epicardium to the pericardium ( 5 ). Right heart failure and cardiac tamponade are also common complications ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Thromboembolism and Hemorrhagic Pericardial Effusion—The Janus Face of Primary Pericardial Angiosarcoma

Chen

Jiang

Dong

et al. 2021

Front. Cardiovasc. Med.

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Background: Primary cardiac angiosarcomas, especially those originating in the pericardium, are extremely rare and aggressive tumors with poor prognosis. These types of malignant tumors have diverse clinical presentations and are often masked by other comorbidities.Case Summary: Our hospital reported a 59-year-old woman who initially presented with pulmonary thromboembolism (PTE) and was subsequently treated with low-molecular-weight heparin. However, she experienced acute pericardial tamponade after anticoagulation therapy, where no obvious mass was primarily identified upon imaging, both in the pericardium or within the heart. Emergency pericardiocentesis and drainage were performed, where a total of 210 mL of bloody effusion was drained. Four months later, she was hospitalized with progressive hemoptysis and dyspnea. A large mixed mass occupying the right pericardium was later identified by coronary computed tomography angiography (CCTA). The mass was consistent with the right atrium, with heterogeneous thickened pericardium and localized moderate pericardial effusion. CCTA and positron emission tomography scans later showed metastases in both lungs and bilateral pleura. Nodules in hilar and mediastinal lymph nodes were also significant. Ultrasound-guided biopsy was performed, and the patient was ultimately diagnosed with an angiosarcoma based on final positive results for both CD31 and CD34 markers. The patient refused chemotherapy and passed away while waiting for her pathology results. The patient survived for 6 months since the first reported episode of PTE.Conclusions: Our case indicates that patients presenting with both embolism and hemorrhage should urgently be channeled to a clinical specialist to confirm any malignant etiology. This would be beneficial to confirm an early diagnosis and lengthen the duration of patient survival. However, the diagnosis of primary cardiac angiosarcoma is still challenging and requires multiple imaging modalities and biopsies in order to assist the accurate diagnosis of disease and achieve effective patient management.

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“…31 CMR is the gold standard for assessing right ventricular function and a well-validated modality to study pericardial disease and myocardial malignancy. 32 Like the general population, cardiac catheterization remains the gold standard for the diagnosis and In conclusion, as patients with HIV are living longer, the prevalence of developing chronic disease with predominant cardiovascular manifestations is growing. The need for better diagnostic and therapeutic interventions for cardiovascular manifestations using multimodality imaging will be the next frontier.…”

Section: Role Of Imaging Modalities In Hiv-related Heart Diseasementioning

confidence: 99%