Published in:
01-12-2011 | Original Paper
The usefulness of delayed contrast-enhanced cardiovascular magnetic resonance imaging in differentiating cardiac tumors from thrombi in stroke patients
Authors:
Yoo Jin Hong, Jin Hur, Young Jin Kim, Hye-Jeong Lee, Ji Eun Nam, Hee Yeong Kim, Kyu Ok Choe, Byoung Wook Choi
Published in:
The International Journal of Cardiovascular Imaging
|
Special Issue 1/2011
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Abstract
The objectives of this study were to evaluate the diagnostic value of delayed-enhancement cardiovascular magnetic resonance (DE-CMR) imaging in differentiating cardiac tumors from thrombi in patients with suspected cardio-embolic stroke. Two radiologists blinded to the study protocol retrospectively evaluated MR images of 22 patients (12 men and 10 women; mean age 59.2 years) that had recently experienced a stroke and undergone CMR. Six cardiac tumors and 16 thrombi were confirmed on surgery or follow-up examinations. On DE-CMR, a tumor was defined as an intracardiac mass showing post-contrast enhancement, and a thrombus was defined as an intracardiac mass showing black signal intensity (SI) without post-contrast enhancement. The mean SI in regions of interest in the normal myocardium and cardiac mass were measured using cine-CMR and DE-CMR. Visual assessment of enhancement characteristics of cardiac masses on DE-CMR could accurately differentiate cardiac tumors from thrombi in all cases. On cine-CMR, the mean SI ratios for tumors and thrombi were 1.45 ± 0.45 (range, 1.12–2.16) and 1.39 ± 0.33 (range, 0.87–2.09), respectively (P = 0.745). On DE-CMR, the mean SI ratios for tumors and thrombi were 5.65 ± 2.96 (range, 2.98–9.92) and 1.06 ± 0.43 (range, 0.67–1.95), respectively (P < 0.001). DE-CMR is a non-invasive modality for detecting intra-cardiac mass can differentiate tumors from thrombi in cardio-embolic stroke patients.