Visualization of cardiac tumors and masses

Abstract

Compared to other referrals, multi-slice CT imaging of cardiac masses is rather uncommon. Twodimensional echocardiography is still the modality of choice in screening for cardiac masses (Felner 1985, Salcedo 1992, Link 1995), as it represents an easy, non-invasive real-time approach with bedside capabilities. Assuming optimal examination circumstances, 2D echocardiography can detect cardiac masses and even small masses attached to the cardiac valves as well as their impact on valve and global cardiac function within the same examination (Olson 1996). However, image quality is mainly dependent on the patient's habitus and the examiner's skills. Restrictions arise in examining obese patients due to the resulting limited acoustic windows, and right ventricle assessment may be hampered in patients with pulmonary emphysema. Also, evaluation of the extra-cardiac extent of a mass might not be assessable. Multi-slice CT imaging has been proven to generate artifact-free cross-sectional images that can be reconstructed in any desired plane. Cardiac motion can be frozen at any time point of the cardiac cycle and the high spatial resolution allows assessment of the cardiac anatomy and morphology (Wintersperger 2003). The large field-of-view (FoV) in a scan plane of usually 50 cm enables not only visualization of the heart itself but also of the surrounding mediastinal structures and the entire chest. This may be especially valuable in patients with advanced malignant cardiac masses. Although the work-up of patients with cardiac masses is not the primary focus of multi-slice cardiac CT imaging, this technique still provides a valuable tool in such cases and as a complementary analysis in patients who undergo examination of the coronary arteries. Beside the evaluation of solid cardiac tumors, there is increasing evidence that multi-slice cardiac CT is a very sensitive technique in screening for ventricular and atrial thrombi. © 2007 Springer-Verlag Berlin Heidelberg.