Incremental diagnostic utility of delayed enhancement CMR tissue characterization for detection of catheter associated right atrial thrombus

Andrew Plodkowski,Jennifer Liu,Yulia Lakhman,Jiwon Kim,Richard Steingart,Stephen Solomon,Dipti Gupta,Nancy Roistacher,Jonathan W Weinsaft,Nina Kukar

doi:10.1186/1532-429x-17-s1-p327

Andrew Plodkowski, Jennifer Liu + Show 8 more

Open Access

https://doi.org/10.1186/1532-429x-17-s1-p327

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Abstract

Methods The population comprised consecutive patients with central venous catheters undergoing CMR at Memorial Sloan Kettering Cancer Center (NY, NY). Delayed enhancement CMR (inversion recovery GRE) was used to identify RT; defined as a right atrial (RA) mass with avascular tissue characteristics (non-enhancing) on “long TI” (600msec) DE-CMR. Cine-CMR (SSFP) was used to quantify cardiac structure and function, including RA and RV function and chamber size. Clinical indices were categorized based on medical record review. Echo (if performed within 14 days of CMR) was retrieved from image archives and independently read for RT. Clinical records were queried for documented pulmonary embolus (PE) within 60 days of CMR.

Highlights

Right atrial thrombus (RT) provides a rationale for anticoagulation and substrate for embolic events
RT was present in 22% (n=11); all had RT avascularity confirmed by dedicated “long TI” DE-CMR
Patients with RT had similar right-sided structure and function vs. those without RT based on right atrial (RA) end-diastolic area (10.2±3.5 vs. 10.2±2.1 cm2/m2, p= 0.94), RA end-systolic area (6.9±3.7 vs. 6.6±1.9 cm2/m2, p=0.76), RV enddiastolic volume (73±21 vs. 67±16 ml/m2, p= 0.27), and RVEF (57±8 vs. 59±9%, p= 0.40)

Summary

Methods

The population comprised consecutive patients with central venous catheters undergoing CMR at Memorial Sloan Kettering Cancer Center (NY, NY). Delayed enhancement CMR (inversion recovery GRE) was used to identify RT; defined as a right atrial (RA) mass with avascular tissue characteristics (non-enhancing) on “long TI” (600msec) DE-CMR. Cine-CMR (SSFP) was used to quantify cardiac structure and function, including RA and RV function and chamber size. Clinical indices were categorized based on medical record review. Echo (if performed within 14 days of CMR) was retrieved from image archives and independently read for RT. Clinical records were queried for documented pulmonary embolus (PE) within 60 days of CMR

Results

Conclusions

Transthoracic Echo*