Myxoma echocardiography or ultrasound: Difference between revisions

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{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} {{MV}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} {{MV}}
==Overview==
==Overview==
On cardiac [[ultrasound]], myxoma is characterized by the presence of a [[heterogeneous]] pedunculated mass that is commonly located in the [[left atrium]]. Cardiac myxomas appear as hyperechogenic lesions with a well-defined stalk. Moreover, [[echocardiography]] can be useful to assess the mobility of the tumor, as it often protrude through valve flaps.Echocardiography is useful to evaluate the function identification and evaluation of cardiac myxomas. As an imaging modality, [[two-dimensional echocardiography]] is often coupled with other testing modalities (such as,Doppler echocardiography) to detect vascular abnormalities that frequently occur in cardiac myxomas. <ref name="pmid2605587">{{cite journal |vauthors=Bentivoglio M, Savino K, Corea L, Verdecchia P, Porcellati C |title=[Doppler echocardiography in atrial myxoma] |language=Italian |journal=Cardiologia |volume=34 |issue=9 |pages=783–6 |year=1989 |pmid=2605587 |doi= |url=}}</ref>
On cardiac [[ultrasound]], myxoma is characterized by the presence of a [[heterogeneous]] pedunculated mass that is commonly located in the [[left atrium]]. Cardiac myxomas appear as hyperechogenic lesions with a well-defined stalk. Moreover, [[echocardiography]] can be useful to assess the mobility of the tumor, as it often protrudes through valve flaps. Echocardiography is useful to evaluate the function identification and evaluation of cardiac myxomas. As an imaging modality, [[two-dimensional echocardiography]] is often coupled with other testing modalities (such as, Doppler echocardiography) to detect vascular abnormalities that frequently occur in cardiac myxomas. <ref name="pmid2605587">{{cite journal |vauthors=Bentivoglio M, Savino K, Corea L, Verdecchia P, Porcellati C |title=[Doppler echocardiography in atrial myxoma] |language=Italian |journal=Cardiologia |volume=34 |issue=9 |pages=783–6 |year=1989 |pmid=2605587 |doi= |url=}}</ref>


==Echocardiography==
==Echocardiography==

Revision as of 13:45, 30 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Maria Fernanda Villarreal, M.D. [3]

Overview

On cardiac ultrasound, myxoma is characterized by the presence of a heterogeneous pedunculated mass that is commonly located in the left atrium. Cardiac myxomas appear as hyperechogenic lesions with a well-defined stalk. Moreover, echocardiography can be useful to assess the mobility of the tumor, as it often protrudes through valve flaps. Echocardiography is useful to evaluate the function identification and evaluation of cardiac myxomas. As an imaging modality, two-dimensional echocardiography is often coupled with other testing modalities (such as, Doppler echocardiography) to detect vascular abnormalities that frequently occur in cardiac myxomas. [1]

Echocardiography

Echocardiography is useful to evaluate tumor mobility on of cardiac myxoma, as it often protrude through valve flaps. As a test modality, two-dimensional echocardiography is often coupled with other modalities (such as, Doppler echocardiography) to detect vascular abnormalities that frequently occur in cardiac myxomas. [1]


Gallery

Echocardiogram apical 4-chamber image view of atrial myxoma[2]



Imaging Technique Features Description Advantages Limitations
Two- or three-dimensional echocardiography Echocardiography is usually the initial modality used for identification and evaluation of cardiac myxomas
  • Hyperechogenic lesions with a well-defined stalk
  • Protrusion into the ventricles is a common finding
  • Real-time imaging
  • Tumor mobility and distensibility
  • Limited views of the mediastinum and cannot be used to evaluate extracardiac manifestations of disease[3]
  • TEE is an invasive imaging technique
  • TT is limited by the imaging window, which can vary with the patient and operator experience
MRI Evaluation of cardiac masses and is of greatest value when echocardiographic findings are suboptimal or when the lesion has an atypical location or appearance
  • Cardiac myxomas appear spherical or ovoid with lobular contours, irregular in shape
  • T1 : Low to intermediate signal, but areas of hemorrhage may be high
  • T1 C+ (Gd): shows enhancement (important discriminator from a thrombus) demonstrates uniform heterogeneous enhancement
  • MRI allows imaging in multiple planes
  • Provides some functional information such as, flow direction and flow velocity in large vessels[4]
  • Cannot show calcification
  • High susceptibility to motion artifact
  • Dependent on regular electrocardiographic rhythms and cardiac gating
CT CT can be used to accurately image the heart and surrounding mediastinum
  • Intracardiac heterogeneously low attenuating mass
  • The attenuation is usually lower than that of myocardium
  • Calcification is common
  • CT provides better soft-tissue contrast
  • There is no real-time true imaging with CT and imaging planes are limited to those allowed by angulation of the gantry.
  • There is no evaluation of small moving structures, such as the cardiac valves
Angiography Coronary angiography may be helpful to detect vascular supply of the tumor by the coronary arteries
  • The angiographic findings of cardiac myxoma demonstrate feeding vessels, contrast medium poolings, and clusters of tortuous vessels that correspond to tumor vasculature
  • Angiography can detect the concomitant coronary disease and the unique vascular appearances of cardiac myxoma
  • Helpful for surgical evaluation
  • Invasive imaging technique
Chest x-ray Chest x-ray has no particular findings associated with cardiac myxoma
  • Results can be normal
  • Low cost
  • May be helpful, if calcifications present
  • Does not provide a diagnosis

References

  1. 1.0 1.1 Bentivoglio M, Savino K, Corea L, Verdecchia P, Porcellati C (1989). "[Doppler echocardiography in atrial myxoma]". Cardiologia (in Italian). 34 (9): 783–6. PMID 2605587.
  2. Atrial Myxoma. Wikipedia.https://en.wikipedia.org/wiki/Atrial_myxoma Accessed November 25,2015 on
  3. Reeder GS, Khandheria BK, Seward JB, Tajik AJ (1991). "Transesophageal echocardiography and cardiac masses". Mayo Clin. Proc. 66 (11): 1101–9. PMID 1943240.
  4. Araoz PA, Eklund HE, Welch TJ, Breen JF (1999). "CT and MR imaging of primary cardiac malignancies". Radiographics. 19 (6): 1421–34. doi:10.1148/radiographics.19.6.g99no031421. PMID 10555666.


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