Assessment of cardiac masses: magnetic resonance imaging versus transthoracic echocardiography

Narin, Burcu; Arman, Alper; Arslan, Deniz; Şimşek, Mikdat; Narin, Ahmet

doi:10.5152/akd.2010.016

Cited by 21 publications

(14 citation statements)

References 13 publications

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“…In a study of 28 patients with intracardiac masses diagnosed by ECHO (transthoracic in all; transesophageal in 9), Gulati et al reported that all 28 patients were confirmed positive for masses by CMR and 6 additional masses were subsequently detected in these 28 patients by CMR. Narin et al evaluated 23 patients with CMR within a period of 1–2 weeks after intracardiac masses were suspected by TTE. CMR diagnosed a cardiac mass in 65% (15/23) of these patients.…”

Section: Discussionmentioning

confidence: 99%

Can cardiovascular MRI be used to more definitively characterize cardiac masses initially identified using echocardiography?

et al. 2018

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In diagnosing cardiac and paracardiac masses, cardiac MRI (CMR) has gained acceptance as the gold standard. CMR has been observed to be superior to echocardiography in characterizing soft-tissue structures and, specifically, in classifying cardiac masses. The aim of our study was to evaluate the association between mortality and cardiac or paracardiac masses initially identified by echocardiography (ECHO) and confirmed by CMR. Between January 2002 and August 2007, a total of 158 patients underwent both ECHO and CMR for the evaluation of cardiac masses that were equivocal or undefined by ECHO. The primary study endpoints were 5-year all-cause mortality and 5-year cardiac mortality. Causes of death as of April 1, 2015 were obtained from medical records or the National Death Index. Patients were analyzed according to mass type determined by CMR using the Kruskal-Wallis test, Kaplan-Meier curves, and the log-rank test. Over a mean duration of follow-up of 10.4 ± 2.9 years (range: 0.01-12 years) post-CMR, the overall all-cause mortality rate was 25.9% (41/158). Median age at death was 76 years and there were 21 females (51.2%). Mortality rates in the different classifications of cardiac masses by CMR were as follows: 20% (1/5) in patients with a Nondiagnostic CMR; 20% (1/5) in Other Diagnoses; 17.9% (7/39) in No Masses (includes Normal Anatomical Variants); 16.7% (3/18) in Benign Masses; 23.8% (15/63) in Fat; 50% (5/10) in Thrombus; and 61.5% (8/13) in Malignant Mass. The mean survival time in patients with No Mass (n = 39) was not significantly longer than patients with any type of cardiac mass (n = 114) (P = .16). No significant difference was found in age at death between patients when grouped by CMR classification (P = .40). However, among CMR-confirmed masses, there were some significant differences by mass classification type (P = .006). During the follow-up period, 26% (41/158) of patients died and 22% (9/41) of the deaths were cardiovascular related; there was no significant difference in mean survival times with respect to cause of mortality (P = .23). In patients with cardiac masses, dually confirmed by ECHO and CMR, significant differences in survival time were observed based upon CMR classified type of mass while CMR was instrumental in obviating invasive biopsy.

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Section: Discussionmentioning

confidence: 99%

Can cardiovascular MRI be used to more definitively characterize cardiac masses initially identified using echocardiography?

et al. 2018

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“…Although TEE appears to be superior to TTE, in many patients it is not performed on a routine basis and should be considered when the transthoracic study is suboptimal. Doppler echocardiography can show the haemodynamic consequences of atrial myxoma 16 –18…”

Section: Discussionmentioning

confidence: 99%

A large left atrial myxoma causing multiple cerebral infarcts

2013

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A 52-year-old man presented with a history of sudden onset diplopia. On neurological examination, the only abnormality was a right-sided oculomotor (third nerve) palsy. A brain CT was performed and reported as showing no abnormality. He was discharged to be investigated as an outpatient. He presented 1 month later with a new expressive dysphasia and confusional state. MRI was performed which revealed multiple cerebral infarcts. He was discharged on secondary stroke prevention medication. Six months elapsed, before a transthoracic echocardiogram was performed. This showed a large left atrial myxoma. The patient underwent an emergency resection and made a good postoperative recovery. This case report showed the importance of considering a cardiogenic source of emboli in patients who present with cerebral infarcts. Performing echocardiography early will help to detect treatable conditions such as atrial myxoma, and prevent further complications.

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“…It also allows the detection of myocardial infiltration by the tumor or expansion of the mass to the pericardium or to adjacent structures [20]. C-MRI may also contribute to the characterization of the composition of the tumor by studying the signal in T1- and T2-weighted images, as well as the enhancement of the signal after gadolinium administration.…”

Section: Diagnostic Evaluation (Figure 1)mentioning

confidence: 99%

Cardiac Tumors

et al. 2011

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Cardiac tumors represent a relatively rare, yet challenging diagnosis. Secondary tumors are far more frequent than primary tumors of the heart. The majority of primary cardiac tumors is benign in origin, with primary malignant tumors accounting for 25% of cases. Metastatic tumors usually arise from lung, breast, renal cancer, melanomas, and lymphomas. Clinical manifestations of cardiac tumors depend on the size and location of the mass and the infiltration of adjacent tissues rather than the type of the tumor itself. Echocardiography is the main diagnostic tool for the detection of a cardiac mass. Other imaging modalities (C-MRI, C-CT, 3D Echo) may offer further diagnostic information and the establishment of the diagnosis is made with histological examination. Management depends on the type of the tumor and the symptomatology of the patient.

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Assessment of cardiac masses: magnetic resonance imaging versus transthoracic echocardiography

Cited by 21 publications

References 13 publications

Can cardiovascular MRI be used to more definitively characterize cardiac masses initially identified using echocardiography?

Can cardiovascular MRI be used to more definitively characterize cardiac masses initially identified using echocardiography?

A large left atrial myxoma causing multiple cerebral infarcts

Cardiac Tumors

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