CT for intracardiac thrombi and tumors

Abstract

Although cardiac tumors are rare, they nevertheless represent an important subgroup, the diagnosis of which is challenging for the primary care physician. Symptoms are not characteristic and serious complications including stroke, myocardial infarction and even sudden death from arrhythmia may be the first signs of tumor. The most common primary cardiac neoplasm is the benign myxoma and the most frequent primary malignant lesion is sarcoma. Cardiac metastases from distant primary carcinomas are now frequently encountered. Echocardiography until the past decade was the only consistently reliable and available non-invasive diagnostic tool. New non-invasive CT and MRI exams are changing the diagnostic approach. Echocardiography and angiocardiography with or without coronary arteriography remain routine methods for evaluating cardiac neoplasms. However, CT provides additional diagnostic information and is regarded as essential for adequate staging and treatment planning, particularly when surgical resection is being considered. This chapter reviews the wide spectrum of intracardiac thrombi and tumors including their incidence and imaging characteristics with particular reference to the CT findings and differential diagnosis.

Caseous calcification of the mitral annulus imaged with 64-slice multidetector CT and magnetic resonance imaging

“…[13][14][15][16][17][18][19]. Alkadhi, et al [17] reported on 64-slice MDCT imaging of a similar mass with peripheral calcification and central hyperdensity.…”

Imaging of Cardiac and Pericardial Masses

“…The crista terminalis is a normal anatomical structure that may sometimes be mistaken for a tumor [18]. Thrombi are also common, and can usually be distinguished from tumors such as myxomas by shape and location [11]. Thrombi are usually smaller than myxomas, do not enhance, and are typically located in the left atrial appendage or posterior wall; myxomas tend to be attached at the fossa ovalis.…”

“…Echocardiography, chest radiography, computed tomography (CT), and magnetic resonance (MR) imaging, with or without electrocardiogram (ECG)-gating, are frequently used modalities for evaluating cardiac masses [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Cardiac masses can be classified by location as intraluminal (including valvular and non-valvular), mural, and pericardial.…”

Asymptomatic cardiac lipoma originating from the interventricular septum diagnosed by multi-slice computed tomography

“…The major technical disadvantages of CT, namely single slice scan acquisition and poor temporal resolution have been greatly reduced by the introduction of MSCT combined with ECG gating. Even without gating any CT scanner can provide useful diagnostic images of many intracardiac lesions [11]. In conclusion, we demonstrated the value of cardiac MSCT to diagnose an interventricular lipoma.…”