Learning objectives
To include the cardiac metastatic disease in the broad spectrum of the differential diagnosis of non-specific clinical manifestations of Acute Coronary Syndrome (ACS).
To understand the importance of CT/MR imaging in diagnosing cardiac metastatic disease.
To highlight the main imaging features in CT/MRI of the less infrequent metastatic lesions of the heart.
Background
Acute Coronary Syndrome is defined as a spectrum of clinical presentations ranging from those for ST-segment elevation myocardial infarction (STEMI) to presentations found in NSTEMI or in unstable angina. It is almost always associated with rupture of an atherosclerotic plaque and partial or complete thrombosis of the infarct-related artery [13].
Myocardial and pericardial metastases are uncommon lesions with an incidence of 1.5% to 20% of autopsies in end-staging cancer patients [1].The pericardium is the most frequently invaded cardiac site, usually by lung carcinoma.
The origin...
Findings and procedure details
In this section, we discuss the main CT and MR features of cardiac metastases and present selected cases with cardiac metastatic disease from our hospital.
Generally, metastatic cardiac tumors will have the same imaging features as other malignant tumors. They will show low signal intensity on T1-weighted images and high on T2-weighted images, except for metastatic melanoma, which, due to the presence of paramagnetic melanin, may present bright not only on T2-weighted images but also on T1-weighted images. Furthermore, they will present restriction in diffusion-weighted...
Conclusion
Radiologists should be aware of the possibility of metastatic cardiac disease in any patient with known malignancy and new cardiac symptoms, particularly with distant metastases or thoracic involvement [12]. Imaging techniques such as CT (CT coronography) and MRI have to be considered one of their main diagnostic tools. The advantages of these methods - the localization of the primary and metastatic tumor, its morphology and texture, its extension locally and its consequences - make them essential in the diagnosis but also the therapeutic planning of...
Personal information and conflict of interest
A. Davidhi; Thessaloniki/GR - nothing to disclose K. Kouskouras; Thessaloniki/GR - nothing to disclose C. Fotiadou; Thessaloniki/GR - nothing to disclose E. Lazaridou; Thessaloniki/GR - nothing to disclose A. Kalogera-Fountzila; Thessaloniki/GR - nothing to disclose
References
[1]A. Al-Mamgani, L. Baartman, M. Baaijens, I. De Pree, L. Incrocci, and P. C. Levendag, “Cardiac metastases,” Int. J. Clin. Oncol., vol. 13, no. 4, pp. 369–372, 2008.
[2]P. J. Sparrow, J. B. Kurian, T. R. Jones, and M. U. Sivananthan, “MR imaging of cardiac tumors,” Radiographics, vol. 25, no. 5, pp. 1255–1276, 2005.
[3]B. I. et al., “Metastatic cardiac tumors: From clinical presentation through diagnosis to treatment,” BMC Cancer, vol. 18, no. 1, pp. 1–9, 2018.
[4]R. Prasad, S. Karmakar, and A. Hussain, “Cardiac...