scholarly journals A concealed carcinoid cardiac metastasis uncovered by comprehensive cardiovascular magnetic resonance-based tissue characterization: a case report

2020 ◽  
Author(s):  
Georgios Georgiopoulos ◽  
Panagiota Mitropoulou ◽  
Pier Giorgio Masci ◽  
Juerg Schwitter
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Case Report ◽  
Magnetic Resonance ◽  
Tissue Characterization ◽  
Carcinoid Tumour ◽  
Whole Body ◽  
Cardiac Metastasis ◽  
Emission Computed Tomography ◽  
Carcinoid Tumours ◽  
Cardiac Metastases

Abstract Background Cardiac metastases of carcinoid tumours are extremely rare, and their diagnosis poses a significant challenge. A variety of techniques has been reported in the literature for this purpose, ranging from echocardiogram to the Indium-111 Octreotide, positron emission tomography using specific tracers, and biopsy. Occasionally, the diagnosis is only made post-mortem. Recently, CMR (cardiovascular magnetic resonance) has been added to the diagnostic toolkit. This case report describes the CMR sequences that can be used to characterize cardiac metastases of carcinoid tumours. Case summary A 55-year-old woman with an antecedent history of resected carcinoid tumour of the ileocecal junction underwent whole-body In-111 Octreoscan single-photon emission computed tomography in the context of her follow-up. This raised the suspicion of pericardial involvement, which prompted a CMR study. Comprehensive CMR findings were consistent with isolated carcinoid tumour metastasis embedded within the anterior papillary muscle. We describe the CMR sequences that were used to characterize the metastasis. Discussion The rarity of cardiac metastasis of carcinoid tumour makes its diagnosis challenging and warrants a high level of clinical suspicion. Cardiovascular magnetic resonance imaging proves to be an indispensable tool in the tissue characterization of such tumours.

scholarly journals Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Caglayan Geredeli ◽  
Melih Cem Boruban ◽  
Necdet Poyraz ◽  
Mehmet Artac ◽  
Alpay Aribas ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Uterine Cervix ◽  
Tissue Characterization ◽  
Primary Melanoma ◽  
Diagnostic Techniques ◽  
Cardiac Metastasis ◽  
Cardiac Tumors ◽  
Malignant Melanomas ◽  
Cardiac Metastases

Primary malignant melanomas of uterine cervix are quite rarely seen neoplasms, and long-life prognosis of patients with this disease is poor. Immunohistochemical methods and exclusion of other primary melanoma sites are used to confirm the diagnosis. As with other melanomas, cervix malignant melanomas may also cause cardiac metastases. Cardiac metastases are among rarely seen but more commonly encountered cases, compared to primary cardiac tumors. Here, we present a case of biatrial cardiac metastases in a 73-year-old patient with uterine cervix malignant melanomas. The patient underwent echocardiography, cardiac magnetic resonance imaging, and computed tomography. Our report shows the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but for a better anatomic definition and tissue characterization. Although the cases of malignant melanomas leading to multiple cardiac metastasis were reported in literature, the metastatic concurrence of malignant melanomas in both right and left atriums is quite rarely encountered as metastatic malignant melanomas. Also, another intriguing point in our case is that the primary lesion of our case was stemmed from uterine cervix, but not skin.

Cardiac metastasis of osteosarcoma

Open Medicine ◽  
2010 ◽  
Vol 5 (5) ◽  
pp. 551-555
Author(s):  
Hilal Sahin ◽  
Naim Ceylan ◽  
Selen Bayraktaroglu ◽  
Recep Savas
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Case Reports ◽  
Primary Tumour ◽  
Cardiac Metastasis ◽  
Imaging Findings ◽  
Cardiac Metastases ◽  
Enhanced Computed Tomography ◽  
Demographic Features

AbstractCardiac osteosarcoma metastasis is extremely rare and is documented in several case reports in the literature. The behaviour of osteosarcoma metastases is similar to the primary tumour. Thoracic non-enhanced computed tomography (CT) examination is beneficial in the detection of calcific cardiac metastases. In this case report, we describe a 29-year-old woman with cardiac osteosarcoma metastasis after 7 years of follow-up, compare the demographic features with previous cases and discuss the imaging findings.

Cardiac Pseudotumor: Tissue Characterization by Cardiovascular Magnetic Resonance

2003 ◽  
Vol 5 (3) ◽  
pp. 497-500 ◽  
Author(s):  
James C. C. Moon ◽  
Mary N. Sheppard ◽  
G. Lloyd ◽  
Nikhil R. Patel ◽  
Dudley J. Pennell ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Tissue Characterization

scholarly journals Hepatic T2-times on cardiovascular magnetic resonance imaging reflect liver fibrosis and predict outcome in an all-comer cohort

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Mascherbauer ◽  
C Dona ◽  
M Koschutnik ◽  
C Nitsche ◽  
V Dannenberg ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Liver Fibrosis ◽  
Tissue Characterization ◽  
Cox Regression ◽  
Imaging Modality ◽  
Hepatic Tissue ◽  
Alcoholic Fatty Liver ◽  
Nafld Fibrosis Score ◽  
Myocardial T1

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is associated with dismal outcomes in patients with cardiac disorders but infrequently assessed by cardiologists. Cardiovascular magnetic resonance (CMR) is evolving as one-stop-shop imaging modality in cardiology, allowing for non-invasive myocardial tissue characterization by T1-mapping. On standard CMR exams, hepatic tissue is also assessable on T1-maps. However, it is unknown whether hepatic T1-times are associated with 1) myocardial T1-times, 2) established NAFLD scores, and 3) outcomes in patients referred for CMR. Methods In consecutive patients undergoing CMR we assessed hepatic and myocardial T1-times, and the NAFLD Fibrosis Score (NFS). Correlation analyses were used to test the association between hepatic and myocardial T1-times as well as the NFS. We used Kaplan-Meier estimates and Cox-regression models to investigate the association between hepatic T1-times and a composite endpoint of heart failure hospitalization and cardiovascular death. Results 513 patients were included (57±18 y/o, 49% female). Hepatic T1-times were 588±98ms on average and were correlated with myocardial T1-times (r=0.42, p<0.001) and – weakly – with the NFS (r=0.11, p=0.04). Patients with severe liver fibrosis or cirrhosis (n=47) had significantly higher hepatic T1-times as compared to patients with no or mild fibrosis based on the NFS (635±197ms versus 588±80ms, p=0.02). During follow-up (100±40 months), a total of 137 (27%) events occurred. When stratified by quartiles, patients in the highest hepatic T1-time quartile (>700ms) were at higher risk for events compared to all other quartiles (log-rank, p=0.01), which was consistent across different NAFLD risk groups based on the NFS (no/mild fibrosis, indeterminant score, severe fibrosis/cirrhosis). On Cox regression analyses, higher hepatic T1-times yielded significantly higher risk estimates for events (adj. HR 1.20 [95% CI: 1.04–1.38] per 1-SD increase, p=0.01) even when adjusted for age, sex, left and right ventricular ejection fractions, and myocardial T1-times. Conclusion Hepatic T1-times assessed on standard CMR reflect severity of NAFLD and predict outcome on top of established risk factors, including myocardial T1-times, in an all-comer CMR cohort. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Medical University of Vienna

scholarly journals Towards Replacing Late Gadolinium Enhancement with Artificial Intelligence Virtual Native Enhancement for Gadolinium-Free Cardiovascular Magnetic Resonance Tissue Characterization in Hypertrophic Cardiomyopathy

Circulation ◽  
2021 ◽  
Author(s):  
Qiang Zhang ◽  
Matthew K. Burrage ◽  
Elena Lukaschuk ◽  
Mayooran Shanmuganathan ◽  
Iulia A. Popescu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cardiovascular Magnetic Resonance ◽  
Deep Learning ◽  
Late Gadolinium Enhancement ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Image Quality ◽  
Tissue Characterization ◽  
Wilcoxon Test ◽  
Gadolinium Enhancement

Background: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging is the gold standard for non-invasive myocardial tissue characterization, but requires intravenous contrast agent administration. It is highly desired to develop a contrast-agent-free technology to replace LGE for faster and cheaper CMR scans. Methods: A CMR Virtual Native Enhancement (VNE) imaging technology was developed using artificial intelligence. The deep learning model for generating VNE uses multiple streams of convolutional neural networks to exploit and enhance the existing signals in native T1-maps (pixel-wise maps of tissue T1 relaxation times) and cine imaging of cardiac structure and function, presenting them as LGE-equivalent images. The VNE generator was trained using generative adversarial networks. This technology was first developed on CMR datasets from the multi-center Hypertrophic Cardiomyopathy Registry (HCMR), using HCM as an exemplar. The datasets were randomized into two independent groups for deep learning training and testing. The test data of VNE and LGE were scored and contoured by experienced human operators to assess image quality, visuospatial agreement and myocardial lesion burden quantification. Image quality was compared using nonparametric Wilcoxon test. Intra- and inter-observer agreement was analyzed using intraclass correlation coefficients (ICC). Lesion quantification by VNE and LGE were compared using linear regression and ICC. Results: 1348 HCM patients provided 4093 triplets of matched T1-maps, cines, and LGE datasets. After randomization and data quality control, 2695 datasets were used for VNE method development, and 345 for independent testing. VNE had significantly better image quality than LGE, as assessed by 4 operators (n=345 datasets, p<0.001, Wilcoxon test). VNE revealed characteristic HCM lesions in high visuospatial agreement with LGE. In 121 patients (n=326 datasets), VNE correlated with LGE in detecting and quantifying both hyper-intensity myocardial lesions (r=0.77-0.79, ICC=0.77-0.87; p<0.001) and intermediate-intensity lesions (r=0.70-0.76, ICC=0.82-0.85; p<0.001). The native CMR images (cine plus T1-map) required for VNE can be acquired within 15 minutes. Producing a VNE image takes less than one second. Conclusions: VNE is a new CMR technology that resembles conventional LGE, without the need for contrast administration. VNE achieved high agreement with LGE in the distribution and quantification of lesions, with significantly better image quality.

scholarly journals Society for Cardiovascular Magnetic Resonance (SCMR) recommended CMR protocols for scanning patients with active or convalescent phase COVID-19 infection

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sebastian Kelle ◽  
Chiara Bucciarelli-Ducci ◽  
Robert M. Judd ◽  
Raymond Y. Kwong ◽  
Orlando Simonetti ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Function ◽  
Tissue Characterization ◽  
Clinical Indication ◽  
Myocardial Tissue ◽  
Clinical Question ◽  
Convalescent Phase ◽  
Myocardial Tissue Characterization

Abstract The aim of this document is to provide specific recommendations on the use of cardiovascular magnetic resonance (CMR) protocols in the era of the COVID-19 pandemic. In patients without COVID-19, standard CMR protocols should be used based on clinical indication as usual. Protocols used in patients who have known / suspected active COVID-19 or post COVID-19 should be performed based on the specific clinical question with an emphasis on cardiac function and myocardial tissue characterization. Short and dedicated protocols are recommended.

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