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Updated: Jun 27, 2026
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Clinical utility of delayed-contrast computed tomography for tissue characterization of cardiac thrombus
Daniel G Krauser1, Matthew D Cham, Anthony J Tortolani
1Division of Cardiology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, NY 10021, USA.
Insights
Cardiac thrombus can be identified by its lack of contrast uptake on delayed-contrast cardiac computed tomography (CT) scans. This imaging technique aids in diagnosing cardiac thrombus, differentiating it from other masses.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Cardiac masses require accurate diagnosis for effective patient management and prognosis.
- Distinguishing thrombus from other cardiac masses can be challenging based on structural imaging alone.
- Tissue characteristics, particularly vascularity, are key differentiators.
Observation:
- A patient presented with a large mass in the left atrium.
- Delayed-contrast cardiac computed tomography (CT) was utilized for diagnostic assessment.
- The absence of contrast uptake in the mass was a notable finding.
Findings:
- Thrombus is avascular, meaning it lacks blood vessels.
- Absence of contrast uptake is a highly specific indicator of thrombus.
- Delayed-contrast CT effectively identified cardiac thrombus in this case.
Implications:
- Delayed-contrast CT can be a valuable tool for diagnosing cardiac thrombus.
- This technique enhances the ability to differentiate thrombus from other cardiac masses.
- Improved diagnostic accuracy for cardiac thrombus can lead to better clinical decisions and outcomes.
Abstract:
Among patients that present with cardiac masses, thrombus is an important diagnostic consideration that affects both clinical management and prognosis. Although thrombus can occasionally be difficult to diagnose using structural criteria alone, it can be distinguished from other structures according to tissue characteristics. Because thrombus is inherently avascular, absence of contrast uptake was used as a highly specific identifying feature. Delayed-contrast cardiac computed tomography (CT) imaging has been previously used for myocardial tissue characterization, distinguishing between viable and infarcted myocardium based upon differences in contrast uptake. This technique also offers potential diagnostic utility for assessment of thrombus. In this report, we describe a case of a patient with a giant left atrial mass in whom delayed-contrast CT was employed as a useful diagnostic technique for identification of cardiac thrombus.
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