title: The usefulness of delayed contrast-enhanced cardiovascular magnetic resonance imaging in differentiating cardiac tumors from thrombi in stroke patients.
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.
authors: 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.
authors: Yoo Jin
authors: YJ
authors: Hong
authors: Jin
authors: J
authors: Hur
authors: Young Jin
authors: YJ
authors: Kim
authors: Hye-Jeong
authors: HJ
authors: Lee
authors: Ji Eun
authors: JE
authors: Nam
authors: Hee Yeong
authors: HY
authors: Kim
authors: Kyu Ok
authors: KO
authors: Choe
authors: Byoung Wook
authors: BW
authors: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000150:complications / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications*; D013927:Thrombosis / Q000150:complications / Q000473:pathology*
chemical_list: D003287:Contrast Media