Utility of parametric T1 mapping by cardiac MRI in the assessment of a rare case of pericardial angiosarcoma

Gautam Sen, Mojisola Giwa, Mauricio Arias, Stefania Rosmini*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

A 60-year-old male with a history of myeloma was admitted with chest pain. Echocardiography showed a large pericardial effusion and therapeutic pericardiocentesis was performed removing 1300 mL of blood-stained fluid. Biochemical analysis revealed an exudate with scanty pus cells and negative cytology. Culture and molecular studies for pyogenic bacteria and Mycobacterium tuberculosis were negative.

Cardiac magnetic resonance (CMR) showed a pericardium circumferentially infiltrated by an aggressive process (Figure 1A), with native T1 mapping in keeping with a heterogeneous composition with soft tissue (Figure 1B, white circle), calcification (Figure 1B, yellow circle) and bloody loculations (Figure 1C, black arrow). The heart was encapsulated by the process causing constriction with evidence of diastolic interventricular septal bounce. First-pass perfusion demonstrated regions of heterogeneous enhancement in keeping with a vascularized process. Late post-contrast images showed diffuse enhancement of the pericardium, large poorly vascularized loculations, and focal myocardial infiltration at the mid-anterior wall (Figure 1D).
Original languageEnglish
Pages (from-to)e289
JournalEuropean heart journal. Cardiovascular Imaging
Volume24
Issue number10
Early online date5 Aug 2023
DOIs
Publication statusPublished - 1 Oct 2023

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