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Cardiac sarcomas are a rare occurrence. They represent one-quarter of all malignant cardiac tumors, and usually have a dismal overall outcome. Diagnosis of these tumors can be challenging, since most of these cases are diagnosed intra-operatively, and may often be mistaken with myxomas. Surgical resection is currently the best option. However, the approach used for surgery depends on the type of tumor, the location of the tumor, and the extent of myocardial involvement. This information can be obtained pre-operatively using Cardiac Magnetic resonance (CMR), which may help improve the overall outcome.
We prospectively enrolled patients with cardiac tumors. Patients with cardiac sarcomas and myxomas were selected for this analysis. CMR images were read for morphologic and tissue characteristics by an experienced cardiologist, who was blinded to the diagnosis of the tumor.
There were 25 patients who had cardiac sarcomas, and 10 patients who had myxomas. Table 1shows a comparison of patient and tumor characteristics. The patients with sarcoma were younger, and more likely to have invasion of the free wall or other structures. CMR tissue characterization revealed increased first pass perfusion with sarcomas, as opposed to myxomas. The sensitivity of first pass perfusion alone was found to be 88%, with an associated likelihood ratio of 2.93.
Dedicated CMR is an excellent tool for identifying the possibility of cardiac sarcoma; a guide to surgical therapy.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: MRI Ill – CMR in Myocardial Disease and Dysfunction
Abstract Category: 19. Imaging: MRI
Presentation Number: 1184-366
- 2013 American College of Cardiology Foundation