Learning objectives
Cardiac fibroma (CF) is a benign tumor and the correct diagnosis targets treatments. CFs have typical but not unique cardiac magnetic resonance (CMR) characteristics.
The main aim is to evaluate the CMR characteristics and to hypothesize that T1 maps and the extracellular volume (ECV) can be crucial for the diagnosis of cardiac fibroma.
Background
The cardiac tumor is extremely rare in children, but fibromas are the second most common type of pediatric cardiac tumor, after rhabdomyoma, and the most cardiac resected neoplasms in the pediatric population [1-3].
Cardiac fibromas are mainly composed of connective tissue and fibroblast. Although benign, they can be symptomatic due to inflow and outflow tract obstruction, intracavitary obstruction, coronary artery impairment, thromboembolic events, conduction defects, and can also lead to sudden death [4]. Their clinical presentation depends upon their location and size.
Echocardiography and MR...
Findings and procedure details
We evaluated CMR exams of 5 patients with a diagnosis of cardiac fibroma [(4 females, 80%), mean age 11 years (range 5-20)]. They had ECG alterations but no symptoms. All studies were performed using a 1.5 T MR Scanner.
The standard protocol comprises:
·bright blood cine images (steady-state free precession techniques) short axis, 2,3 and 4 chambers;
·T1 and T2 weighted images, double-inversion recovery fast-spin echo short axis (black-blood technique);
·first-pass perfusion images by fast gradient recalled-echo-planar technique immediately after a gadolinium bolus injection;
·delayed...
Conclusion
Cardiac fibromas typically arise in the ventricular myocardium, most commonly the ventricular septum, as found in our cases, or the left ventricular free wall [1,6]. Often, this localization induces conduction system disease with resulting rhythm abnormalities, as well as in our patients.
In our little sample, the cardiac fibromas were in all cases homogeneous.
However, the presence of intralesional calcification is described in the literature, which can be seen as patchy hypointense foci within the lesion [7,8].
According to the literature, they showed little or...
Personal information and conflict of interest
S. Pradella; Florence/IT - nothing to disclose M. Letteriello; Florence/IT - nothing to disclose C. de Amicis; Florence/IT - nothing to disclose M. Acquafresca; Florence/IT - nothing to disclose E. Bertelli; Florence/IT - nothing to disclose G. Grazzini; Florence/IT - nothing to disclose V. Miele; Florence/IT - nothing to disclose
References
1)
1
1) Sargar KM,Sheybani EF,Shenoy A, Aranake-Chrisinger J, Khanna G. Pediatric Fibroblastic and Myofibroblastic Tumors: A Pictorial Review. Radiographics. 2016 Jul-Aug;36(4):1195-214.
2) Uzun O, Wilson DG, Vujanic GM, Parsons JM, De Giovanni JV. Cardiac tumours in children. Orphanet J Rare Dis 2007; 2:11.
3) Torimitsu S, Nemoto T, Wakayama M, et al. Literature survey on epidemiology and pathology of cardiac fibroma. Eur J Med Res 2012; 17:5.
4) Rajput FA, Limaiem F. StatPearls CardiacFibroma. Treasure Island (FL): StatPearls [Internet]. Publishing; 2019 Jan-2019 Dec 6....