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Diffuse infiltrative cardiac tuberculosis.

Gulati GS, Kothari SS - Ann Pediatr Cardiol (2011)

Bottom Line: We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis.Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers.The lesions showed significant resolution on antitubercular therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi - 110 029, India.

ABSTRACT
We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy.

No MeSH data available.


Related in: MedlinePlus

Cardiac magnetic resonance images. (a and b) Axial T1-weighted images showing isointense masses (arrows) along the anterior right atrium (*), right ventricular outflow tract (#), and along both ventricles (+ indicates left ventricle). (c) Short axis T2-weighted image showing that the lesions are mildly hyperintense. (d) Steady state free precession image revealing the infiltrative nature of the lesion along the left ventricle. The delayed enhanced short axis image (e) shows heterogenous enhancement of the mass
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Figure 3: Cardiac magnetic resonance images. (a and b) Axial T1-weighted images showing isointense masses (arrows) along the anterior right atrium (*), right ventricular outflow tract (#), and along both ventricles (+ indicates left ventricle). (c) Short axis T2-weighted image showing that the lesions are mildly hyperintense. (d) Steady state free precession image revealing the infiltrative nature of the lesion along the left ventricle. The delayed enhanced short axis image (e) shows heterogenous enhancement of the mass

Mentions: A cardiac magnetic resonance (CMR) imaging (1.5 T, Magnetom Avanto, Siemens, Germany) was performed. Spin- echo T1-weighted axial images [Figure 3a and b] showed isointense, multiple, discrete or contiguous, nodular infiltrative masses along the anterior wall of the right atrium (which was dilated), right ventricular outflow tract, and along both the right and the left ventricles. The lesions appeared to predominantly involve the outer myocardium, with the pericardium being indistinct in several places. There was no mediastinal lymphadenopathy and no pleural or pericardial effusions. On the spin- echo T2-weighted images [Figure 3c], the lesions were isointense to mildly hyperintense. The steady state free precession (SSFP) sequence [Figure 3d] showed the lesions to be homogenously hyperintense with reduced systolic ventricular function. On the delayed enhanced sequence [Figure 3e], the lesions enhanced with small areas of heterogeneity. There was no thrombus. A non-contrast computed tomography of the chest was also performed and was normal. Differential diagnosis included metastasis, sarcoma, and lymphoma. In view of the clinical history, absence of imaging characteristics typical of these lesions, and our own experience with imaging of cardiac tuberculosis, the latter was strongly considered and antitubercular therapy was initiated. Tissue diagnosis was not performed.


Diffuse infiltrative cardiac tuberculosis.

Gulati GS, Kothari SS - Ann Pediatr Cardiol (2011)

Cardiac magnetic resonance images. (a and b) Axial T1-weighted images showing isointense masses (arrows) along the anterior right atrium (*), right ventricular outflow tract (#), and along both ventricles (+ indicates left ventricle). (c) Short axis T2-weighted image showing that the lesions are mildly hyperintense. (d) Steady state free precession image revealing the infiltrative nature of the lesion along the left ventricle. The delayed enhanced short axis image (e) shows heterogenous enhancement of the mass
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104545&req=5

Figure 3: Cardiac magnetic resonance images. (a and b) Axial T1-weighted images showing isointense masses (arrows) along the anterior right atrium (*), right ventricular outflow tract (#), and along both ventricles (+ indicates left ventricle). (c) Short axis T2-weighted image showing that the lesions are mildly hyperintense. (d) Steady state free precession image revealing the infiltrative nature of the lesion along the left ventricle. The delayed enhanced short axis image (e) shows heterogenous enhancement of the mass
Mentions: A cardiac magnetic resonance (CMR) imaging (1.5 T, Magnetom Avanto, Siemens, Germany) was performed. Spin- echo T1-weighted axial images [Figure 3a and b] showed isointense, multiple, discrete or contiguous, nodular infiltrative masses along the anterior wall of the right atrium (which was dilated), right ventricular outflow tract, and along both the right and the left ventricles. The lesions appeared to predominantly involve the outer myocardium, with the pericardium being indistinct in several places. There was no mediastinal lymphadenopathy and no pleural or pericardial effusions. On the spin- echo T2-weighted images [Figure 3c], the lesions were isointense to mildly hyperintense. The steady state free precession (SSFP) sequence [Figure 3d] showed the lesions to be homogenously hyperintense with reduced systolic ventricular function. On the delayed enhanced sequence [Figure 3e], the lesions enhanced with small areas of heterogeneity. There was no thrombus. A non-contrast computed tomography of the chest was also performed and was normal. Differential diagnosis included metastasis, sarcoma, and lymphoma. In view of the clinical history, absence of imaging characteristics typical of these lesions, and our own experience with imaging of cardiac tuberculosis, the latter was strongly considered and antitubercular therapy was initiated. Tissue diagnosis was not performed.

Bottom Line: We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis.Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers.The lesions showed significant resolution on antitubercular therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi - 110 029, India.

ABSTRACT
We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy.

No MeSH data available.


Related in: MedlinePlus