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Updated: Sep 30, 2025

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Atypical Intracavitary Cardiac Mass: Tumor or Thrombus?
Adeyinka Adeniyi1, Sandra Abadir1, Kalindi Parikh2
1Internal Medicine, Wellstar Atlanta Medical Center, Atlanta, USA.
Insights
Contrast perfusion echocardiography can identify cardiac mass malignancy, avoiding costly CT or CMR scans. This non-invasive technique improves diagnosis in resource-limited settings.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Cardiac masses are rare, often thrombi or vegetations, but tumors require differentiation.
- Cardiovascular magnetic resonance (CMR) and CT are established for mass characterization.
- Accurate diagnosis is crucial for appropriate patient management.
Observation:
- This case report focuses on contrast perfusion imaging via echocardiography.
- Transesophageal echocardiography with contrast effectively identified cardiac mass etiology.
- This method was used as an alternative to CMR and cardiac CT.
Findings:
- Contrast perfusion echocardiography accurately differentiated cardiac mass types.
- This technique provided diagnostic information without requiring CMR or CT.
- Significant cost savings ($100-$1207) were observed compared to advanced imaging.
Implications:
- Echocardiography with contrast offers a cost-effective diagnostic tool for cardiac masses.
- This approach enhances diagnostic capabilities in smaller facilities with limited resources.
- It facilitates timely diagnosis and management of cardiac masses, improving patient outcomes.
Abstract:
Cardiac masses are a rare finding, with most masses found being thrombi or vegetations. Still, some masses are suspected to be a tumor based on multiple characteristics such as size, location, mobility, and the tumor's hemodynamic effects. Cardiovascular magnetic resonance (CMR) and CT have been shown to differentiate a tumor from a thrombus based on tissue characteristics of the mass. Here we highlight the role of contrast perfusion imaging on echocardiography in identifying the malignant potential of a cardiac mass. This case report demonstrates the effectiveness of contrast imaging with a transesophageal echocardiogram in identifying the etiology of cardiac masses without the need of CMR or cardiac CT, which helps save between $100-1207 of hospital costs. Besides the cost-benefit, the use of non-invasive and easily accessible imaging like echocardiogram enables smaller facilities with limited resources to diagnose and hence further manage patients with cardiac masses.
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