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The usefulness of delayed contrast-enhanced cardiovascular magnetic resonance imaging in differentiating cardiac tumors from thrombi in stroke patients

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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.

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Abbreviations

DE-CMR:

Delayed-enhancement cardiovascular magnetic resonance

CT:

Computed tomography

CMR:

Cardiovascular magnetic resonance

SI:

Signal intensity

ROI:

Region of interest

MI:

Myocardial infarction

CVA:

Cerebrovascular accident

LA:

Left atrium

LV:

Left ventricle

LAA:

Left atrial appendage

b-FFE:

Balanced steady-state free precession

TR:

Repetition time

TE:

Echo time

T1-TFE:

Segmented inversion recovery radiofrequency spoiled gradient echo

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Acknowledgments

This work was supported by a faculty research grant of Yonsei University College of Medicine (6–2009-0155).

Conflict of interest

I assert that there are no conflicts of interest (both personal and institutional) regarding specific financial interest that are relevant to the work conducted or reported in this manuscript.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea

    Yoo Jin Hong, Jin Hur, Young Jin Kim, Hye-Jeong Lee, Ji Eun Nam, Hee Yeong Kim, Kyu Ok Choe & Byoung Wook Choi

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  1. Yoo Jin Hong
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  2. Jin Hur
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  3. Young Jin Kim
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  4. Hye-Jeong Lee
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  5. Ji Eun Nam
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  6. Hee Yeong Kim
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  7. Kyu Ok Choe
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  8. Byoung Wook Choi
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Correspondence to Jin Hur.

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Hong, Y.J., Hur, J., Kim, Y.J. et al. The usefulness of delayed contrast-enhanced cardiovascular magnetic resonance imaging in differentiating cardiac tumors from thrombi in stroke patients. Int J Cardiovasc Imaging 27 (Suppl 1), 89–95 (2011). https://doi.org/10.1007/s10554-011-9961-8

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  • DOI: https://doi.org/10.1007/s10554-011-9961-8

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