Transthoracic and transesophageal echocardiography were traditionally considered to be the reference standard for evaluation of atrial septal aneurysms (ASA). However, the increasing use and widespread availability of noninvasive modalities characterized by excellent spatial and temporal resolution like ECG-gated MDCT and MRI have permitted the accurate investigation of previously undetected entities like septal aneurysms. Radiologists should be familiar with the imaging findings of atrial septal aneurysms in ECG-gated MDCT and MRI. When dealing with this diagnosis, the presence of interatrial communication and thrombus formation within the...

The term cardiac septal aneurysm is used to describe a deviation of either interatrial or interventricular septum of more than 10-15 mm to either side. The size of the neck of the aneurysm is an important parameter and should measure at least 15 mm but it should not occupy the entire septum. [2] These aneurysms represent a rare but well-described entity with a reported prevalence of 0.2-3% in the general population. Of course, their prevalence is subject to variations depending on the method of diagnosis...

Multidetector computed tomography (MDCT) Echocardiography is the traditional primary imaging modality for cardiac septal aneurysms. Transesophageal echocardiography is reported to adequately visualize the interatrial septum and diagnose ASA in all cases. Transthoracic echocardiography on the other hand may miss up to 47% of ASA detected by the transesophageal technique. [10] However, ECG-gated cardiac MRI and MDCT have emerged as valuable noninvasive cardiac imaging modalities that further evaluate these entities. Newer technologies available and the increasing use of these modalities enable accurate assessment of previously undetected...

ASA represent a group of clinically significant abnormalities. Although ultrasonography is the primary imaging modality to evaluate and diagnose them, it is sometimes limited due to poor acoustic window and thus suboptimal images. Cardiac MRI can be used in these cases to accurately evaluate and measure ASA. MRI has also the advantage to further evaluate heart as a whole with excellent spatial and temporal resolution and evaluate complex cardiac abnormalities from both an anatomic and physiologic point of view. The use of ECG-gated technique is...

Vasileios Rafailidis, Lydia Kalogeropoulou, Georgios Papadopoulos, Anna Maria Papaioannou, Stefanos Finitsis, Anna Kalogera-Fountzila, Afroditi Charitanti-Kouridou, Constantinos Kouskouras. Department of Radiology, AHEPA University General Hospital,Aristotle University of Thessaloniki, Thessaloniki, Greece.

1. Zeina AR. Usefulness of 64-slice computed tomography for evaluation of atrial septal aneurysm. Isr Med Assoc J 2011; 13:645-646. 2. Dodd JD, Aquino SL, Holmvang G, Cury RC, Hoffmann U, et al. Cardiac septal aneurysm mimicking pseudomass: appearance on ECG-gated cardiac MRI and MDCT. AJR Am J Roentgenol 2007; 188:W550-553. 3. Carcano C, Kirsch J. "Hidden Danger" a case report on interatrial septal aneurysm. Int J Cardiovasc Imaging 2012; 28:1545-1546. 4. Czekajska-Chehab E, Tomaszewski A, Tomaszewska M, Siek E, Uhlig S, et al. ECG-gated...