The role of computed tomography in the differential diagnosis of an intracardiac mass of the mitral valve: a case series

Мұқаба

Дәйексөз келтіру

Толық мәтін

Аннотация

The differential diagnosis of an echocardiographically detected intracardiac mass in the mitral annulus can be challenging and usually requires a multimodal approach. This type of lesion is very often associated with subvalvular calcification of the mitral valve. The rare, caseous, variant is the most difficult to diagnose. This case series highlights the clinical significance of computed tomography in detecting and characterizing subvalvular mitral annular calcification when other modalities, particularly echocardiography, are inconclusive. The aim of this article was to raise awareness among specialists of the classic signs of caseous subvalvular calcification of the mitral annulus when visualized with different modalities. Special attention is also given to providing a differential diagnostic series that identifies features that differentiate subvalvular calcification of the mitral annulus from other conditions at this site. Healthcare professionals need to be aware of these mitral valve lesions in order to predict possible associated complications and plan a treatment strategy that may help avoid unnecessary surgical procedures in some cases.

Толық мәтін

##article.viewOnOriginalSite##

Авторлар туралы

Maria Onoyko

Lomonosov Moscow State University

Хат алмасуға жауапты Автор.
Email: onoykomary@gmail.com
ORCID iD: 0000-0002-7727-3360
SPIN-код: 6380-7495

MD

Ресей, Moscow

Elena Mershina

Lomonosov Moscow State University

Email: elena_mershina@mail.ru
ORCID iD: 0000-0002-1266-4926
SPIN-код: 6897-9641

MD, Cand. Sci. (Medicine), Assistant Professor

Ресей, Moscow

Amalia Arakelyants

Lomonosov Moscow State University; Sechenov First Moscow State Medical University

Email: nxrrimma@mail.ru
ORCID iD: 0000-0002-1243-2471
SPIN-код: 4990-6008

MD, Cand. Sci. (Medicine)

Ресей, Moscow

Valentin Sinitsyn

Lomonosov Moscow State University

Email: vsini@mail.ru
ORCID iD: 0000-0002-5649-2193
SPIN-код: 8449-6590

MD, Dr. Sci. (Medicine), Professor

Ресей, Moscow

Әдебиет тізімі

  1. Savage DD, Garrison RJ, Castelli WP, et al. Prevalence of submitral (anular) calcium and its correlates in a general population based sample (the Framingham Study). Am J Cardiol. 1983;51(8):1375–1378. doi: 10.1016/0002-9149(83)90315-6
  2. Abramowitz Y, Jilaihawi H, Chakravarty T, et al. Mitral Annulus Calcification. J Am Coll Cardiol. 2015;66(17):1934–1941. doi: 10.1016/j.jacc.2015.08.872
  3. Kanjanauthai S, Nasir K, Katz R, et al. Relationships of mitral annular calcification to cardiovascular risk factors: the Multi Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 201;213(2):558–562. doi: 10.1016/j.atherosclerosis.2010.08.072
  4. Harpaz D, Auerbach I, Vered Z, et al. Caseous calcification of the mitral annulus: a neglected, unrecognized diagnosis. J Am Soc Echocardiogr. 2001;14(8):825–831. doi: 10.1067/mje.2001.111877
  5. Silbiger JJ. Anatomy, mechanics, and pathophysiology of the mitral annulus. Am Heart J. 2012;164(2):163–176. doi: 10.1016/j.ahj.2012.05.014
  6. Deluca G, Correale M, Ieva R, et al. The incidence and clinical course of caseous calcification of the mitral annulus: a prospective echocardiographic study. J Am Soc Echocardiogr. 2008;21(7):828–833. doi: 10.1016/j.echo.2007.12.004
  7. Akram M, Hasanin AM. Caseous mitral annular calcification: Is it a benign condition? J Saudi Hear Assoc. 2012;24(3):205–208. doi: 10.1016/j.jsha.2012.02.003
  8. Hamirani YS, Nasir K, Blumenthal RS, et al. Relation of mitral annular calcium and coronary calcium (from the Multi Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol. 2011;107(9):1291–1294. doi: 10.1016/j.amjcard.2011.01.005
  9. Shriki J, Rongey C, Ghosh B, et al. Caseous mitral annular calcifications: Multimodality imaging characteristics. World J Radiol. 2010;2(4):143-147. doi: 10.4329/wjr.v2.i4.143
  10. Gravina M, Casavecchia G, Manuppelli V, et al. Mitral annular calcification: Can CMR be useful in identifying caseous necrosis? Interv Med Appl Sci. 2019;11(1):71-73. doi: 10.1556/1646.10.2018.47
  11. Mayr A, Müller S, Feuchtner G. The Spectrum of Caseous Mitral Annulus Calcifications. JACC Case Rep. 2021;3(1):104–108. doi: 10.1016/j.jaccas.2020.09.039
  12. Belkind MB, Butorova EA, Stukalova OV, et al. Caseous calcification of the mitral annulus. Eurasian heart journal. 2023;(4):90–93. doi: 10.38109/2225-1685-2023-4-90-93
  13. Saidova MA, Atabaeva LS, Stukalova OV. Caseous calcification of the mitral annulus. Russian Cardiology Bulletin. 2019;14(3):62–67. doi: 10.36396/MS.2019.14.03.010

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
2. 1. Transthoracic echocardiography, B-mode — clinical case 1: a–c — volumetric formation in the posterior flap of the mitral valve; d — signs of mitral regurgitation during Dopplerography; a — parasternal access, long axis of the left ventricle; b — apical four-chamber position; c — parasternal access, short axis on mitral valve level; d — apical two-chamber position.

Жүктеу (238KB)
3. Fig. 2. Computed tomography of the heart with ECG synchronization - clinical case 1: a—c – with contrast enhancement in the "bone window"; d — without contrast in the "soft tissue window"; subcarvular caseous calcification of the posterior mitral valve: a — three—chamber view; b —four-chamber view; c — image along the short axis at the level of the mitral valve; d is the axial projection.

Жүктеу (200KB)
4. 3. Computed tomography of the heart with ECG synchronization - clinical case 2: a—c – with contrast enhancement in the "bone window"; d — without contrast in the "soft tissue window"; subcarvular caseous calcification of the posterior mitral valve leaflet: a — four—chamber view; b — two-chamber view along the long axis of the left ventricle; c is the image along the short axis at the level of the mitral valve; d is the axial projection.

Жүктеу (155KB)
5. 4. Clinical case 3: a–c — magnetic resonance imaging of the heart; d — computed tomography of the heart with ECG synchronization; green arrows - formation in the posterior flap of the mitral valve in a patient with transmural postinfarction scar in the lower wall of the left ventricle at the level of the basal and middle sections (red arrows); a–b — SSFP (Steady-State Free Precession) sequences, two-chamber view along the long axis of the left ventricle, without contrast; c — T1-weighted image with suppression of the signal from the myocardium and delayed contrast enhancement, two-chamber view along the long axis of the left ventricle; d — axial projection, "bone window".

Жүктеу (188KB)

© Eco-Vector, 2024

Creative Commons License
Бұл мақала лицензия бойынша қол жетімді Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).