The imaging features of neurologic complications of left atrial myxomas.
BACKGROUND
Neurologic complications may be the first symptoms of atrial myxomas. Understanding the imaging features of neurologic complications of atrial myxomas can be helpful for the prompt diagnosis.


OBJECTIVE
To identify neuroimaging features for patients with neurologic complications attributed to atrial myxoma.


METHODS
We retrospectively reviewed the medical records of 103 patients with pathologically confirmed atrial myxoma at Xiangya Hospital from January 2009 to January 2014. The neuroimaging data for patients with neurologic complications were analyzed.


RESULTS
Eight patients with atrial myxomas (7.77%) presented with neurologic manifestations, which constituted the initial symptoms for seven patients (87.5%). Neuroimaging showed five cases of cerebral infarctions and three cases of aneurysms. The main patterns of the infarctions were multiplicity (100.0%) and involvement of the middle cerebral artery territory (80.0%). The aneurysms were fusiform in shape, multiple in number (100.0%) and located in the distal middle cerebral artery (100.0%). More specifically, high-density in the vicinity of the aneurysms was observed on CT for two patients (66.7%), and homogenous enhancement surrounding the aneurysms was detected in the enhanced imaging for two patients (66.7%).


CONCLUSIONS
Neurologic complications secondary to atrial myxoma consist of cerebral infarctions and aneurysms, which show certain characteristic features in neuroimaging. Echocardiography should be performed in patients with multiple cerebral infarctions, and multiple aneurysms, especially when aneurysms are distal in location. More importantly, greater attention should be paid to the imaging changes surrounding the aneurysms when myxomatous aneurysms are suspected and these are going to be the relevant features in our article.
Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Wei-Hua
WH
Liao
Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Divya
D
Ramkalawan
Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Jian-Ling
JL
Liu
Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Wei
W
Shi
Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Chi-Shing
CS
Zee
Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Xiao-Su
XS
Yang
Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Guo-Liang
GL
Li
Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Jing
J
Li
Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China. Electronic address: cjr.wangxiaoyi@vip.163.com.
Xiao-Yi
XY
Wang
D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000175:diagnosis* / Q000503:physiopathology; D059906:Neuroimaging / Q000379:methods*; D012189:Retrospective Studies; D013923:Thromboembolism / Q000150:complications* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
Cerebral complications; Left atrial myxoma; Neuroimaging