Multimodality imaging assessment of a caseous calcification of the mitral valve annulus
Autor: | Wafa Fehri, Khalil Houissa, Dhaker Lahidheb, Younes Arous, Mehdi Ghommidh, A. Haggui, Nadhem Hajlaoui, Habib Haouala, Nejmeddine Ben Abdallah, Chadia Chourabi, I. Hamdi |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system Case Report 030204 cardiovascular system & hematology Echocardiograpgy 030218 nuclear medicine & medical imaging Imaging Calcification Coronary artery disease 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Mitral valve medicine Mitral Valve Annulus cardiovascular diseases CMR Abscess Cardiac imaging Mitral regurgitation medicine.diagnostic_test business.industry medicine.disease medicine.anatomical_structure lcsh:RC666-701 cardiovascular system Radiology business |
Zdroj: | Journal of the Saudi Heart Association, Vol 30, Iss 1, Pp 55-58 (2018) |
ISSN: | 1016-7315 |
Popis: | Caseous calcification of the mitral annulus (CCMA) is a rare echocardiographic finding. It is commonly misdiagnosed as an abscess, tumor or infective vegetation on the mitral valve. Since it is a benign process, differentiating it from malignant intra-cardiac mass is primordial to avoid unnecessary surgery. Various imaging modalities can be complimentary for definitive diagnosis. We present a case of CCMA in a 71-year-old female patient. Her medical history revealed hypertension, diabetes mellitus, hyperlipidaemia and coronary artery disease. She was referred to our department for coronary catheterization because of angina symptoms upon minimal exertion. The lesion was detected during echocardiography and was defined as a mass of heterogeneous content with calcification points, located at the posterior side of the mitral valve annulus. Restricted motion of the posterior leaflet and the mass effect caused only minimal mitral regurgitation. To establish the correct diagnosis, we performed the full spectrum of noninvasive cardiac imaging modalities. Transesophageal echocardiography identified well-organized, composite lesion with regular edges, markedly calcified margins and more echolucent central portion. A computed tomography (CT) was performed, showing a hyperdense mass with hypodense center and a calcified peripheral rim located at the posterior mitral ring. Cardiac magnetic resonance imaging (MRI) showed that the mass was hypointense with respect to the myocardium in the T1 and T2-weighted sequences and only presented late-phase enhancement in the surrounding capsule. Based on the CT and MRI findings, the diagnosis of CCMA was established. The patient was managed conservatively. |
Databáze: | OpenAIRE |
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