CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review

Abstract

Cardiac complications with hematologic diseases are not uncommon but it is difficult to diagnose, due to non-specific clinical symptoms. Prompt recognition of these potentially fatal complications by cardiac computed tomography (CT) or cardiac magnetic resonance imaging (MRI) may help to direct clinicians to specific treatments according to causes. Thrombosis is often related to central venous catheter use and is usually located at the catheter tip near the atrial wall. Differentiation of thrombosis from normal structure is possible with CT and, distinction of a thrombus from a tumor is possible on a delayed enhancement MRI with a long inversion time (500-600 ms). Granulocytic sarcoma of the heart is indicated by an infiltrative nature with involvement of whole layers of myocardium on CT and MRI. MRI with T2* mapping is useful in evaluating myocardial iron content in patients with hemochromatosis. Diffuse subendocardial enhancement is typically observed on delayed MRIs in patients with cardiac amyloidosis. T1 mapping is an emerging tool to diagnose amyloidosis. Myocardial abscess can occur due to an immunocompromised status. CT and MRI show loculated lesions with fluid density and concomitant rim-like contrast enhancement. Awareness of CT and MRI findings of cardiac complications of hematologic diseases can be helpful to physicians for clinical decision making and treatment.

Risk Factor and Clinical Outcome of Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation

“…Expiratory scans were obtained at the levels of the aortic arch, midway between the aortic arch and the trachea carina, in the tracheal carina, midway between the tracheal carina and the right hemidiaphragm, and 1 cm above the right hemidiaphragm. The reading of HRCT was performed by one radiology specialist (Jung JI 15 16 17 18 19 20 ). During the analysis of each CT examination, the inspiratory images were reviewed before the expiratory images.…”

A wearable cardioverter defibrillator for prevention of sudden cardiac death in a hematologic patient—a case report

“…There is a lack of published data of cardiac involvement within myeloid neoplasia. Only case reports on this topic are available [3,4]. The vast majority of cases can be effectively treated by initiation of a specific therapy, leading to a rapid improvement of cardiac function and preventing sudden cardiac death [5].…”

Myocardial Abscess After Myocarditis

“…1 Transthoracic echocardiogram and transesophageal echocardiogram are helpful primary diagnostic tools but are not sufficient to discriminate the origin of suspicious lesions. 2 CT and CMR are valuable modalities with several advantages. CT scans identify typical abscess characteristics comprising fluid density and contrast-enhancing myocardial wall thickening, as we have shown.…”

“…CT scans identify typical abscess characteristics comprising fluid density and contrast-enhancing myocardial wall thickening, as we have shown. 2 CMR has a superior spatial and temporal resolution, so its sensitivity and specificity to correctly diagnose myocardial abscesses is significantly higher than other imaging tools. 2 CMR detects intramyocardial lesions independent from their origin.…”

“… 2 CMR has a superior spatial and temporal resolution, so its sensitivity and specificity to correctly diagnose myocardial abscesses is significantly higher than other imaging tools. 2 CMR detects intramyocardial lesions independent from their origin. PET-CT scans supported our findings in CMR/CT as we aimed to differentiate between a myocardial abscess from lesions of other origin.…”