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Updated: Sep 28, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Assessment of the vascularity of a left ventricular mass using myocardial contrast echocardiography
Wolfgang Lepper1, Bharati Shivalkar, Diana Rinkevich
1Cardiac Imaging Center, Cardiovascular Division, University of Virginia School of Medicine, Charlottesville 22908, USA.
Insights
Contrast echocardiography can help differentiate cardiac masses by evaluating vascularity. This technique aids in distinguishing tumors from thrombi, crucial for accurate diagnosis and treatment.
Area of Science:
- Cardiology
- Medical Imaging
- Oncology
Background:
- Intracardiac mass lesions can be thrombi, primary tumors, or metastases.
- Echocardiography is key for diagnosis, but features can be ambiguous.
- Vascularity is a potential differentiator between benign and malignant cardiac masses.
Observation:
- A patient with malignant melanoma developed an incidental cardiac mass.
- Contrast echocardiography (CE) was employed to assess the mass's vascularity.
- The case was compared to an apical thrombus, an avascular intracardiac structure.
Findings:
- Contrast echocardiography revealed the vascularity of the cardiac mass.
- Vascularity assessment aids in differentiating cardiac tumors from thrombi.
- Malignant tumors often exhibit higher vascularity than benign tumors or thrombi.
Implications:
- Contrast echocardiography enhances diagnostic accuracy for intracardiac masses.
- Differentiating tumor vascularity can guide treatment strategies.
- This imaging modality is valuable in oncology patients with cardiac findings.
Abstract:
In addition to a thrombus, an intracardiac mass lesion can represent a primary cardiac tumor, or a metastatic lesion to the heart. The echocardiographic appearance and location of the mass, as well as the associated clinical scenario provide useful clues regarding cause, but these echocardiographic features alone may not always be diagnostic. Because most benign cardiac tumors are relatively avascular, the vascularity of a mass may be a feature that can help differentiate benign from malignant tumors. We present a case of a patient with a history of malignant melanoma who was found incidentally to have a cardiac mass on echocardiography. Contrast echocardiography (CE) was used to evaluate the vascularity of the mass. This case is compared with another patient with an apical thrombus, which represents an "avascular" intracardiac structure.
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