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Detection of cardiac myxomas with non-contrast chest CT

Wonseon Shin1, Yeon Hyeon Choe, Sung Mok Kim

  • 1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Acta Radiologica (Stockholm, Sweden : 1987)
|August 9, 2013
PubMed

Insights

Non-contrast CT scans can effectively detect cardiac myxomas, even those without calcification. This imaging technique offers high sensitivity and specificity, aiding in diagnosis when contrast is not administered.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Cardiac myxomas are primary cardiac tumors and a significant source of systemic embolism.
  • Many chest CT and calcium-scoring CT scans are performed without contrast injection, limiting diagnostic capabilities.

Purpose of the Study:

  • To evaluate the diagnostic capability of non-contrast CT scans in detecting cardiac myxomas.
  • Assessing the utility of non-contrast CT for identifying cardiac myxomas in patients where contrast administration is not feasible or indicated.

Main Methods:

  • Retrospective analysis of 36 non-contrast CT scans from patients with left atrial myxomas and 20 control scans.
  • Two blinded readers assessed lesion presence using a five-point scale and measured tumor attenuation and size on non-contrast CT images.

Main Results:

  • Significant differences in attenuation values were observed between cardiac myxomas (mean 22.5 HU) and adjacent blood (mean 44.6 HU).
  • Non-contrast CT demonstrated high sensitivity (88.8%-86.1%) and specificity (95.0%-100%) for detecting cardiac myxomas, with excellent inter-observer reliability (kappa=0.92).
  • Twelve myxomas with internal calcification were detected, and tumor sizes were accurately measured, albeit slightly smaller than pathological specimens.

Conclusions:

  • Non-contrast CT is a valuable tool for detecting cardiac myxomas.
  • Radiologists should be aware of the imaging characteristics of cardiac myxomas on non-contrast CT to improve diagnostic accuracy.
Abstract

Keywords:
Cardiac myxomanon-contrast CTscreening

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