The contribution of magnetic resonance imaging to the evaluation of intracardiac tumors diagnosed by echocardiography.

Freedberg, Robin S.; Kronzon, Itzhak; Rumancik, William M.; Liebeskind, Doreen

doi:10.1161/01.cir.77.1.96

Cited by 138 publications

(49 citation statements)

References 8 publications

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“…No existe una interpretación para explicar esta discrepancia aunque algunos factores como la ecogenicidad atípica y el desarrollo concéntrico del tumor pueden contribuir a ello. La RNM y la ecocardiografía transesofágica parecen ser más prometedoras por su mayor sensibilidad y capacidad resolutiva (5,14).…”

Section: Discussionunclassified

Angiosarcoma pulmonar metastásico

Clemente¹,

Budiño²,

Stein

et al. 2004

An. Med. Interna (Madrid)

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INTRODUCCIÓNEl angiosarcoma es un tumor vascular maligno poco frecuente (1 al 2 % del total de sarcomas). La afectación pulmonar por este tumor no es habitual y suele ser debida a metásta-sis de un tumor primario de otro origen. El diagnóstico de angiosarcoma pulmonar primario es extremadamente raro (1). Dado que la mayor parte de las publicaciones son casos clíni-cos aislados, las manifestaciones y el curso clínico no son bien conocidos. Presentamos un caso de angiosarcoma pulmonar metastásico por su interés y rareza. CASO APORTADOPaciente de 58 años que acudió al servicio de urgencias por hemoptisis de 5 días de evolución. Se trataba de una mujer, no fumadora, con diabetes tipo II controlada con dieta. Padecía desde hacía varios años un síndrome depresivo en tratamiento actualmente con venlafaxina 75 mg al día y alprazolam 0,5 mgr cada 24 horas. Hacía 4 y 2 años había presentado sendos episodios de trombosis venosa profunda. Acudió a urgencias en esta ocasión por notar en los últimos 5 días disnea y expectoración hemoptoica de sangre roja acompañada de coágulos, dolor torácico en hemitórax izquierdo no claramente definido y sensación distérmica. No sín-drome general acompañante. En el examen físico no había datos destacables salvo febrícula de 37,8 ºC y discreta taquicardia sinusal (104 /minuto). En los exámenes complementarios el hemograma, el estudio de coagulación, la bioquímica hepática y el sistemático y sedimento de orina fueron normales. En la bioquímica general solo llamaba la atención una glucemia de 121 mg/dl. La gasometría arterial al ingreso mostraba PaO 2 de 69 mm de Hg, PaCO 2 de 45 mm de Hg, pH de 7,39 y bicarbonato de 25,6 mmol/l. En la radiografía de tórax, se observaron imágenes nodulares bilaterales difusas de diferentes tamaños y en la tomografía axial computerizada 37 [0212-7199 (2004) RESUMENLa afectación pulmonar por angiosarcoma, habitualmente en forma de enfermedad metastásica, es una rara enfermedad. El angiosarcoma pulmonar primario es un tumor extremadamente raro. El pulmón es uno de los lugares más frecuentes de afectación metastásica junto con el híga-do y los ganglios linfáticos. La hemoptisis es el síntomas más frecuente, pudiendo presentarse incluso en forma de hemorragia pulmonar difusa. La radiografía de tórax puede ser normal, pero lo más frecuente es la presencia de múltiples imágenes nodulares. No es habitual que se establezca un diagnóstico precoz por el bajo índice de sospecha derivado de la rareza del tumor. El tratamiento sigue siendo desalentador sobre todo en los angiosarcomas metastásicos cuya supervivencia media es de 9 meses tras el diagnóstico.

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Section: Discussionunclassified

Angiosarcoma pulmonar metastásico

Clemente¹,

Budiño²,

Stein

et al. 2004

An. Med. Interna (Madrid)

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“…However, echocardiography may not allow us to sufficiently evaluate surrounding mediastinal structures, such as the compressed lung seen in this case, and CT and angiography both subject a patient to the risks of contrast medium injection and radiation in repeat studies. Recent literature indicates that MR may in some instances be superior to two-dimensional echocardiography in evaluating the size and relationship of the cardiac tumor and extension to great vessels (6). The addition of MR cine and multiphasic gated spin-echo acquisition techniques allows global evaluation.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of Tumor from Viable Myocardium using Cardiac Tagging with MR Imaging

Bouton¹,

Yang²,

McCrindle³

et al. 1991

Journal of Computer Assisted Tomography

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We report the application of myocardial tagging by MR to define tissue planes and differentiate contractile from noncontractile tissue in a neonate with congenital cardiac rhabdomyoma. Using custom-written pulse programming software, six 2 mm thick radiofrequency (RF) slice-selective presaturation pulses (tags) were used to label the chest wall and myocardium in a star pattern in diastole, ∼60 ms before the R-wave gating trigger. This method successfully delineated the myocardium from noncontractile tumor, providing information that influenced clinical management. This RF tagging technique allowed us to confirm the exact intramyocardial location of a congenital cardiac tumor. KeywordsMagnetic resonance imaging; techniques-Heart; neoplasms-Heart; ventriclesIn the evaluation of neonatal thoracic tumors, precise localization of the tumor and differentiation from viable myocardium are critical in planning surgical treatment. We previously reported the use of myocardial tagging (1) using slice-selective radio-frequency (RF) presaturation followed by MR imaging in the orthogonal plane to evaluate regional leftventricular (LV) function. In this article we report the application of myocardial tagging by MR to define tissue planes and to differentiate contractile from noncontractile tissue in a patient with presumed congenital cardiac rhabdomyoma. CASE REPORTA 3-day-old infant was referred for MR evaluation of a thoracic mass detected first on fetal ultrasound and confirmed later by postnatal echocardiography. Following an uncomplicated vaginal delivery, the patient demonstrated persistent mild respiratory distress with tachypnea, tachycardia, hypoxemia, and hypercapnia. Physical examination showed a well-developed newborn girl with no evident external anomalies. Subcostal retractions and nasal flaring were noted and, on auscultation, a systolic ejection murmur was heard. There was no evidence of congestive heart failure.Chest roentgenography showed a very large cardiac silhouette with compression of the left lung (Fig. 1). Electrocardiography (ECG) showed greatly increased LV forces with marked

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“…The wide field of view, high contrast and spatial resolution, and multiplanar imaging capabilities allow precise demonstration and localization of a tumor, including its anatomic relationship to the cardiac chambers and any involvement of the myocardium, pericardium, or contiguous structures. 8 …”

Section: Commentmentioning

confidence: 99%

Giant Metastatic Alveolar Soft Part Sarcoma in the Left Ventricle: Appearance in Echocardiography, Magnetic Resonance Imaging, and Histopathology

Strecker¹,

Schmid²,

Agaimy³

et al. 2011

Clinical Cardiology

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Alveolar soft part sarcoma is a rare soft‐tissue neoplasm that accounts for <1% of all soft‐tissue sarcomas. Most cases arise in the extremities and head and neck region of young adults. The common sites of metastasis are lung, brain, and bone. Cardiac metastasis is extremely rare, in particular. Here we present the diagnostic evaluation and successful surgical resection of such a cardiac tumor in a patient aged 50 years with a histology‐confirmed diagnosis of metastatic alveolar soft part sarcoma. © 2011 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose.

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The contribution of magnetic resonance imaging to the evaluation of intracardiac tumors diagnosed by echocardiography.

Cited by 138 publications

References 8 publications

Angiosarcoma pulmonar metastásico

Angiosarcoma pulmonar metastásico

Differentiation of Tumor from Viable Myocardium using Cardiac Tagging with MR Imaging

Giant Metastatic Alveolar Soft Part Sarcoma in the Left Ventricle: Appearance in Echocardiography, Magnetic Resonance Imaging, and Histopathology

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