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Magnetic resonance imaging evaluation of cardiac tumor characteristics in infants and children

  • Maria G. Kiaffas
    Affiliations
    Department of Cardiology, Children’s Hospital, Boston, Massachusetts, USA

    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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  • Andrew J. Powell
    Affiliations
    Department of Cardiology, Children’s Hospital, Boston, Massachusetts, USA

    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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  • Tal Geva
    Correspondence
    Dr. Geva’s address is: Department of Cardiology, Children’s Hospital, 300 Longwood Avenue, Boston, Massachusetts, USA 02115.
    Affiliations
    Department of Cardiology, Children’s Hospital, Boston, Massachusetts, USA

    Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
    Search for articles by this author
      Primary cardiac tumors are rare in childhood, with a reported incidence of 0.0017% to 0.027% based on postmortem studies.
      • Straus R.
      • Merliss R.
      Primary tumors of the heart.
      ,
      • Nadas A.S.
      • Ellison R.C.
      Cardiac tumors in infancy.
      With the advent of echocardiography, cardiac tumors have been more readily diagnosed. In 1 study, the prevalence of childhood cardiac tumors had increased approximately fivefold over a 16-year period.
      • Freedom R.M.
      • Lee K.J.
      • MacDonald C.
      • Taylor G.
      Selected aspects of cardiac tumors in infancy and childhood.
      Although most cardiac tumors in pediatric patients are not malignant, they may cause blood flow obstruction, ventricular dysfunction, or arrhythmias that result in significant morbidity and mortality. Rhabdomyoma, which is often associated with tuberous sclerosis, is the most common cardiac tumor diagnosed in children.
      • Freedom R.M.
      • Lee K.J.
      • MacDonald C.
      • Taylor G.
      Selected aspects of cardiac tumors in infancy and childhood.
      ,
      • Beghetti M.
      • Gow R.M.
      • Haney I.
      • Mawson J.
      • Williams W.
      • Freedom R.
      Pediatric primary benign cardiac tumors a 15-year review.
      ,
      • Sallee D.
      • Spector M.L.
      • van Heeckeren D.W.
      • Patel C.R.
      Primary pediatric cardiac tumors a 17 year experience.
      ,
      • Becker A.E.
      Primary heart tumors in the pediatric age group a review of salient pathologic features relevant for clinicians.
      Its echocardiographic features are well established and additional cardiac imaging tests are seldom required for patient management.
      • Beghetti M.
      • Gow R.M.
      • Haney I.
      • Mawson J.
      • Williams W.
      • Freedom R.
      Pediatric primary benign cardiac tumors a 15-year review.
      ,
      • Sallee D.
      • Spector M.L.
      • van Heeckeren D.W.
      • Patel C.R.
      Primary pediatric cardiac tumors a 17 year experience.
      In contrast, specific imaging characteristics of other childhood cardiac tumors are less well defined. Moreover, treatment strategy varies according to tumor type. For example, a Purkinje cell tumor associated with high-grade ventricular ectopy may require surgical resection, whereas a cardiac hemangioma may be treated with high-dose steroids or interferon. Magnetic resonance imaging (MRI) has been shown to provide useful information on tumor location, boundaries, and tissue characteristics in adults.
      • Amparo E.G.
      • Higgins C.B.
      • Farmer D.
      • Gamsu G.
      • Mcnamara M.
      Gated-MRI of cardiac and paracardiac masses initial experience.
      ,
      • Lund J.T.
      • Ehman R.L.
      • Julsrud P.R.
      • Sinak L.J.
      • Tajik A.J.
      Cardiac masses assessment by MR imaging.
      However, only a few studies on MRI evaluation of cardiac tumors include infants and children.
      • Amparo E.G.
      • Higgins C.B.
      • Farmer D.
      • Gamsu G.
      • Mcnamara M.
      Gated-MRI of cardiac and paracardiac masses initial experience.
      ,
      • Lund J.T.
      • Ehman R.L.
      • Julsrud P.R.
      • Sinak L.J.
      • Tajik A.J.
      Cardiac masses assessment by MR imaging.
      ,
      • Boxer R.A.
      • LaCorte M.A.
      • Singh S.
      • Shapiro J.
      • Schiller M.
      • Goldman M.
      • Stein H.L.
      Diagnosis of cardiac tumors in infants by magnetic resonance imaging.
      ,
      • Wann L.S.
      • Sampson C.
      • Liu Y.
      Cardiac and paracardiac masses complementary role of echocardiography and magnetic resonance imaging.
      Furthermore, little information is available regarding MRI tissue characterization of childhood cardiac tumors. The present study, therefore, reports on the evaluation of 11 infants and children with primary cardiac tumors with an emphasis on correlating MRI tumor characteristics with tissue type.
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