Myxoma echocardiography or ultrasound
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Myxoma echocardiography or ultrasound On the Web |
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American Roentgen Ray Society Images of Myxoma echocardiography or ultrasound |
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Risk calculators and risk factors for Myxoma echocardiography or ultrasound |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Maria Fernanda Villarreal, M.D. [3]
Overview
On cardiac ultrasound, myxoma is characterized by the presence of a heterogeneous pedunculated mass that is commonly located in the left atrium. Cardiac myxomas appear as hyperechogenic lesions with a well-defined stalk. Moreover, echocardiography can be useful to evaluate the function identification and evaluation of cardiac myxomas in real-time imaging. As an imaging modality, two-dimensional echocardiography is often coupled with other testing modalities (such as, Doppler echocardiography) to detect vascular abnormalities that frequently occur in cardiac myxomas.[1]
Echocardiography
The echocardiogram is the initial modality and most useful diagnostic imaging study in cardiac myxoma. Echocardiography allows for the accurate assessment of tumor mobility, as it often protrudes through valve flaps. As a test modality, two-dimensional echocardiography is often coupled with other modalities (such as, Doppler echocardiography and M-mode) to detect echogram alterations or flow abnormalities that frequently occur in cardiac myxomas.[1]
Transthoracic echocardiography
Transthoracic echocardiography (TTE) is the imaging method of choice in cardiac myxoma. This imaging study is noninvasive and characterizes heart morphology in a variety of imaging planes that can demonstrate tumor mobility and distensibility.[2] It also provides a large amount of functional information. Transthoracic echocardiography is mainly limited by the available imaging window, which mainly depends on operator experience.[3]
The echocardiographic findings in left cardiac myxoma include: [4]
- The tumor prolapses into the left ventricle (LV) immediately after the opening of the mitral valve at the onset of diastole.
- Tumor masses evoke bandlike echoes behind the anterior mitral leaflet.
- There is a small echo-free gap behind the end-diastolic (DE) amplitude of the anterior mitral leaflet represents the short interval between the opening of the mitral valve and the protrusion of the tumor.
Transesophageal echocardiography
Transesophageal echocardiography (TEE) is an invasive imaging technique it may be helpful in the evaluation of extracardiac structures such as, the descending aorta and pulmonary veins. Unlike transthoracic echocardiography there is no limitation to the acoustic window, better image resolution is often reached. Findings on cardiac myxomas, such as compression of cardiac structures can be better identified by TEE.[5] TEE can also be used to detect small vegetations and tumors (1 to 3 mm in diameter).[6]
Doppler echocardiography
A hallmark feature of Doppler echocardiography in cardiac myxoma is measuring velocity and chamber pressures, it may be helpful in the assessment of cardiac valve areas and function.[7] In some cases, this modality is coupled with contrast-enhanced ultrasound using gas-filled microbubble contrast media to improve velocity or other flow-related measurements.[8]
M-mode
M-mode echogram modality may be helpful to evaluate abnormal echoes within the atrial cavity. Because of spatial limitations, ultrasonic beam may fail to traverse the mass, particularly if the size is small or if the tumor remains within the atrial cavity.[9]
Echocardiography Examples of Cardiac Myxoma
| Imaging Technique | Features | Description | Advantages | Limitations |
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| Two- or three-dimensional echocardiography |
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| MRI |
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| CT |
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| Angiography |
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| Chest x-ray |
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References
- ↑ 1.0 1.1 Bentivoglio M, Savino K, Corea L, Verdecchia P, Porcellati C (1989). "[Doppler echocardiography in atrial myxoma]". Cardiologia (in Italian). 34 (9): 783–6. PMID 2605587.
- ↑ Mundinger A, Gruber HP, Dinkel E, Geibel A, Beck A, Wimmer B, Schlosser V (1992). "Imaging in cardiac mass lesions". Radiat Med. 10 (4): 135–40. PMID 1410560.
- ↑ Araoz PA, Eklund HE, Welch TJ, Breen JF (1999). "CT and MR imaging of primary cardiac malignancies". Radiographics. 19 (6): 1421–34. doi:10.1148/radiographics.19.6.g99no031421. PMID 10555666.
- ↑ Vopat RL, Alpert MA, Flaker GC, Curtis JJ, Webel RR, Sanfelippo JF (1986). "Limitations of echocardiography in the diagnosis of left atrial myxoma: a case report". Angiology. 37 (7): 547–51. PMID 3729078.
- ↑ Engberding R, Daniel WG, Erbel R, Kasper W, Lestuzzi C, Curtius JM, Sutherland GR, Lambertz H, von Hehn A, Lesbre JP (1993). "Diagnosis of heart tumours by transoesophageal echocardiography: a multicentre study in 154 patients. European Cooperative Study Group". Eur. Heart J. 14 (9): 1223–8. PMID 8223737.
- ↑ Stern R (1996). "Cardiac myxomas". N. Engl. J. Med. 334 (21): 1408, author reply 1408–9. PMID 8614442.
- ↑ Okuri H, Shimizu M, Yokoyama K, Kawada H, Irisawa A, Kikawada R (1993). "[A case of right atrial myxoma: M-mode and pulsed-Doppler echocardiographic findings before and after operation]". Kokyu To Junkan (in Japanese). 41 (4): 397–401. PMID 8516580.
- ↑ Doppler echocardiography.Wikipedia. https://en.wikipedia.org/wiki/Doppler_echocardiography Accessed on November 30, 2015
- ↑ Pechacek LW, Gonzalez-Camid F, Hall RJ, Garcia E, de Castro CM, Leachman RD, Montiel-Amoroso G (1986). "The echocardiographic spectrum of atrial myxoma: a ten-year experience". Tex Heart Inst J. 13 (2): 179–95. PMC 324624. PMID 15227359.
- ↑ Atrial Myxoma. Wikipedia.https://en.wikipedia.org/wiki/Atrial_myxoma Accessed November 25,2015 on
- ↑ Reeder GS, Khandheria BK, Seward JB, Tajik AJ (1991). "Transesophageal echocardiography and cardiac masses". Mayo Clin. Proc. 66 (11): 1101–9. PMID 1943240.