| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Bnai-zion Medical Center Haifa 31048, Israel
Atrial septal aneurysm is an uncommon congenital anomaly [1] characterized by a diffuse or localized protrusion of the interatrial septum into the right or left atrium or both. Atrial septal aneurysms have been related to thromboembolic events, atrial septal defects, mitral valve prolapse, systolic clicks, and arrhythmias [1, 2]. The majority of atrial septal aneurysms are detected incidentally. We describe a case of atrial septal aneurysm with no other cardiac abnormalities that was diagnosed by ECG-gated 16-MDCT.
A 72-year-old woman with diabetes mellitus, hypercholesterolemia, atypical chest pain, and a history of palpitations was referred by her cardiologist to our department for cardiac CT angiography (CTA).
After administration of an oral ß-blocker medication, ECG-gated cardiac CTA was performed with 16-MDCT with the patient in the supine position during a single breath-hold (detector collimation, 16 x 0.625 mm; gantry rotation time, 0.42 seconds; tube voltage, 120 kV; and pitch, 0.26). A bolus of 80 mL of iomeprol, 400 mg I/mL (Iomeron 400, Bracco), was injected IV (4 mL/s) via an 18-gauge catheter placed in the antecubital vein followed by 50 mL of saline. Data sets were acquired at phases 45% and 75% of the R-R cycle. The image data sets were analyzed using multiplanar reconstruction and maximum intensity projections in addition to the axial source images. Cardiac CTA revealed a large atrial septal aneurysm located around the fossa ovalis and protruding into the right atrium (Figs. 2A and 2B). The portion of the atrial septum exhibiting aneurysmal dilatation protruded 2 cm beyond the plane of the septum, and the base of the aneurysmal portion was 2.9 cm in diameter. There was no evidence of thrombus formation on the concave aspect of the aneurysm sac, and no other cardiac abnormalities were found. Transthoracic echocardiography showed an atrial septal aneurysm without patent foramen ovale. Bubble contrast and color Doppler echocardiography revealed no right-to-left shunting.
|
|
In our patient, cardiac CTA using an MDCT scanner enabled us to visualize the atrial septal aneurysm in its entirety and to exclude interatrial communication or thrombus formation within the aneurysmal cavity, a possible cause of cardiogenic embolism. MDCT may offer advantages over TEE in this setting. Echocardiographic differentiation between atrial septal aneurysm-attached thrombi and artifacts created by the mobile and bulging part of the fossa ovalis may be difficult in some patients [2]; a tangential scan through a mobile atrial septal aneurysm may create the false impression of a thrombus, the resolution limit influenced by factors such as density of the thrombus and its relation to surrounding blood and tissue [2].
To the best of our knowledge, this report is the first description of atrial septal aneurysm diagnosed with MDCT. Thus, MDCT may serve as another diagnostic technique for detection of interatrial septal abnormality.
 Top References |
|---|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  J. D. Dodd, S. L. Aquino, G. Holmvang, R. C. Cury, U. Hoffmann, T. J. Brady, and S. Abbara Cardiac Septal Aneurysm Mimicking Pseudomass: Appearance on ECG-Gated Cardiac MRI and MDCT Am. J. Roentgenol., June 1, 2007; 188(6): W550 - W553. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
