Curvaceous Cardiac: A Pictorial Review of Unusual Cardiac Aneurysms.

Congress:

ECR 2019

Poster Number:

C-1075

Type:

Educational Exhibit

Keywords:

Cardiac, Cardiovascular system, CT, MR, CT-Angiography, Education, Aneurysms, Congenital, Ischaemia / Infarction

Authors:

B. B. Das, P. Reddy, B. Nagabhushana Reddy, S. T. Prabhakar, S. Viswamitra; Bangalore/IN

DOI:

10.26044/ecr2019/C-1075

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1075

Table 1: Cardiac CT and Cardiac MR protocol for cardiac aneurysms

Table 2: Causes for Cardiac Aneurysms

Fig. 1: Left ventricle diverticulum – 1 year old child presenting with sweating while...

Fig. 2: Congenital LV apical aneurysm / diverticulum – 21 year old male presented...

Learning objectives

1. To illustrate various aneurysms of ventricles and atria. 2. To describe MRI and CT techniques to determine the type of an aneurysm and to describe certain key imaging points which will direct to etiology of cardiac aneurysms. 3. Discuss management options of these aneurysms

Background

Cardiac aneurysms can be caused potentially by wide varieties of aetiologies. Ventricular aneurysms are broadly divided into true and pseudoaneurysms. True aneurysm wall is composed of myocardium and fibrous tissue. While pseudo aneurysm wall is composed of organized hematoma and pericardium with no normal myocardium. It is seen that pseudoaneurysms have more intense enhancement on delayed imaging (1). Cardiac CT and MR aid in non-invasive differentiation between a true and pseudoaneurysm, which is important due to their differential complications and treatment strategies. True aneurysms have...

Findings and procedure details

Cardiac CT and MR studies were evaluated from 2014 to 2018, in total 1520 Cardiac CTs and 1756 cardiac MRs were performed. These cases were then searched with keyword ''aneurysm" in our PACS search engine, we found 28 cases of different cardiac aneurysm with detailed clinical history, lab findings,therapeutic procedure performed and clinical outcomes. These cases were classified as follows- Refer to table 2 CONGENITAL ANEURYSMS A) LEFT VENTRICLE ANEURYSMS 1. Left ventricular diverticulum It is a congenital true aneurysm. It is a diverticulum like...

Conclusion

1. Cardiac CT and Cardiac MR can determine size, extent, mass effect and hemodynamic significance of cardiac aneurysms. 2. They aid in non -invasive differentiation of aneurysms into true and pseudoaneurysms and thus has a vital role in the management of patients. 3. Cardiac MRI protocol should be optimized depending upon clinical suspicion and findings on preliminary images. Optimal protocol and good quality image acquisition lead to an accurate diagnosis. 4. Cardiac CT and MR optimal evaluation as described in this exhibit can suggest probably...

Personal information

References

1. Konen E, Merchant N, Gutierrez C, Provost Y, Mickleborough L, Paul NS, Butany J. True versus false left ventricular aneurysm: differentiation with MR imaging--initial experience. Radiology 2005; 236: 65-70 [PMID: 15955851 DOI: 10.1148/radiol.2361031699]. 2. Kalisz K, Rajiah P. Radiological features of uncommon aneurysms of the cardiovascular system.World J Radiol. 2016;8(5):434-48. 3. Abdusamed AA, Mulatu HA, Martinez RN. Submitral Left Ventricular Aneurysm Associated with Thrombus.Ethiop J Health Sci. 2018;28(1):93-96. 4. Kumar V, Saraf RP, Maiya SS, Suresh PV. Submitral aneurysm in children: A rare entity...