GE Healthcare-Product Technology-Clinical case : Cardiac Scan for Detection of Myxoma in the Left Atrium

Cardiac Scan for Detection of Myxoma in the Left Atrium

Cardiac CT can provide detailed information for evaluation of cardiac masses such as tumors and thrombi.

High-definition imaging of these structures produces surgically-relevant information and at the same time, can rule out coronary disease at very low dose.

Courtesy of Dr. J.L Sablayrolles, Centre Cardiologique du Nord, Saint-Denis, France

The Centre Cardiologique du Nord (CCN) was founded in 1973 by a consortium of cardiologists and established in Saint-Denis, 3 km north of Paris. Its specialty, as can be taken by its name, are cardiovascular pathologies. With more than 180 beds and over 1000 cardiac interventions per year, it is renowned as a center of excellence in the diagnosis and treatment of cardiovascular illnesses. The Radiology Service has been active in the cardiac CT scanning field since the year 2000, having used a LightSpeed VCT and a LightSpeed VCT XT scanner to perform these exams. More recently, their cardiac CT-scanning activity has been passed on to the their newly acquired Discovery™ CT750HD, with more than 800 cardiac scans in 4 months of activity.

Patient History

A 52-year-old female was hospitalized due to fatigue, intermittent fever and an inflammatory syndrome. Associated to these symptoms were chest pain and shortness of breath, but with no cardiovascular risk factors. The patient underwent a cardiac ultrasound in order to rule out cardiovascular diseases as the source of these symptoms. This exam detected an abnormal mass in the left atrium, most probably a myxoma. A cardiac CT scan was thus performed in order to determine the motion of the tumor within the heart as well as evaluate further cardiovascular complications.

Technique

The cardiac CT exam was performed on the new Discovery CT750HD (GE Healthcare), using cardiac mode with retrospective ECG-gating of the heart. The patient’s heart rate was 47 BPM and the resulting dose was estimated to be 5.1 mSv* (299 mGy.cm).

*Dose conversion obtained from EUR-16262 EN with chest factor of DLP*0.017

Findings

Thanks to the CT scan, an oblong myxoma with a volume of 10.1 cm3 was perceived in the left atrium of the heart. It was attached to the inter-ventricular septum and swung from the left atrium into the left ventricle through the mitral valve. The motion of the tumor can be easily observed by engaging Cine-mode, as seen below:
Apart from the tumor in the heart, the patient’s coronary arteries were evaluated. These are normal in size and form, with no significant plaque or stenosis detected.

Conclusion

The dose reduction achieved with the new Discovery CT750HD allowed radiologists to precisely pinpoint the location of the tumor within the patient’s heart and its motion by obtaining all of the heart’s phases at no more than 5.1 mSv.
Moreover, the image quality permitted the evaluation of the patient’s coronary health, ruling out other possible causes for the symptoms.