Abstract:

Aim: was to show possibilities of magnetic resonance imaging (MRI) in the detection and characterization of neoplasms of the heart.

Materials and methods: we retrospectively studied clinical cases of heart neoplasms, diagnosed and operated in Federal National Center of Cardiovascular Surgery (FNCCS) (Penza) since 2008 tc 2014. All patients on admission underwent echocardiography, after which, in some cases to clarify the topography of neoplasms and features of individual anatomy - MRI was performed. In postoperative follow-up period, control studies were conducted. In all cases, the diagnosis was histologically verified. All operated patients were discharged in satisfactory condition. We made a search and analysis of scientific literature on beam diagnostics of space-occupying lesions of heart.

Results: for the period of 6 years, in FNCCS were examined and surgical treatment of more than 30 thousand patients, of which neoplasms of the heart were detected in 25(0.08%) cases. Cardiac myxoma was diagnosed in 19(76%) patients, of whom in 2(8%) cases, the echocardiographic picture was mixed, that had required magnetic resonance imaging. MRI has also been used in 2(8%) patients with benign and malignant transformation of mesenchyoma, and in few cases (4%) rhabdomyomas, lipomatous hypertrophy, atrial septum, epithelioid leiomyoma of the uterus in the germinating atrium and metastatic melanoma. Also, in some cases, the use of MRI allowed to rule out malignancy and to identify mural thrombus. In 1 case, MRI gave, a detailed study of the morphology and localization of tumors to evaluate its spatial relationship with neighboring structures, study of three-dimensional and functional parameters of the heart. Dynamic mode (Cine-SSFP), planar and volumetric reconstruction (MPR) demonstrated the topography of tumors. That helped a broad understanding of the pre-operative pathology and surgical simplified decision-making. MRI allowed to analyze results of surgical correction and implement dynamic monitoring during the early and late postoperative period.

Conclusions: MRI in the diagnosis of tumors of the heart significantly complements echocardiography, providing a non-invasive multi-modal visualization, necessary for a comprehensive assessment of the topography of lesions, detection of individual anatomical features of intracardiac and extracardiac structures. MRI should be included in the diagnostic algorithm of tumors of the heart, including to assess occured hemodynamic changes.  

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Abstract:

Background: case report of a rare congenital anomaly - the diverticulum of the right ventricle of the heart, revealed by echocardiography and magnetic resonance imaging (MRI) of the heart.

Aim: was to show possibilities in detection and differential diagnosis of diverticulum of the right ventricle.

Materials and methods: patient, 23 years, during examination after passed pneumonia, underwent echocardiography wich revealed an aneurysm of right ventricle. Patient underwent further examination: MRI of heart in T1-WS and T2-WS, «gradient echo» and dynamical regime (Cine-SSFP) in standard positions. Demonstration of diverticulum is based on reconstruction imaging (MPR). Results: due to MRI data, in right ventricle we found a bulging 1,2х2,0 cm with clear contours, wich decreased in systole with myocardum of right ventricle - «true diverticulum of right ventricle». We marked difficulties in the diagnosis associated with the paucity of clinical manifestations.

Conclusions: MRI made it possible to study individual morphological anatomy of the diverticulum, to demonstrate and to assess in detail the topography that helped to make decisions on further management of the patient. 

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