- Poster presentation
- Open Access
Thrombus can enhance on delayed enhancement imaging
© Tumma et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Diagnostic Accuracy
- Mitral Valve
- Cardiac Magnetic Resonance
- Cardiac Magnetic Resonance Imaging
- Valve Prosthesis
To examine the diagnostic accuracy of cardiac magnetic resonance imaging (CMR) in differentiating thrombus from myxoma Thrombus is thought not to enhance on CMR, myxomas are thought to show mild heterogenous enhancement on delayed imaging. It is sometimes difficult to differentiate them, and this may lead to misdiagnosis, which would significantly impact treatment. Thrombi can have varying signal intensities depending on their age and fibrous composition in T1 and T2 imaging.
A retrospective review of CMR performed from January 2000 to June 2013 was conducted with waiver of consent which was approved by our institutional review board. Analysis of a total of 46 masses diagnosed as myxoma or thrombus on CMR were compared with histopathology reports or follow up imaging to determine the diagnostic accuracy of CMR. All patients underwent CMR on a 1.5 Tesla scanner with EKG gating following the same protocol.
Delayed enhancement is one of the important factors distinguishing a myxoma from a thrombus. However we found in our study that some thrombi may show mild delayed enhancement because of varying tissue composition and result in a misdiagnosis. CMR evaluation can also be difficult in the presence of artifacts (motion, valve prosthesis, intracardiac leads) and arrhythmias. Thrombi may show patchy enhancement on delayed imaging and can be confused as atrial myxoma on CMR.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.