Skip to main content

Advertisement

SpringerLink
Log in

CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Cardiac complications with hematologic diseases are not uncommon but it is difficult to diagnose, due to non-specific clinical symptoms. Prompt recognition of these potentially fatal complications by cardiac computed tomography (CT) or cardiac magnetic resonance imaging (MRI) may help to direct clinicians to specific treatments according to causes. Thrombosis is often related to central venous catheter use and is usually located at the catheter tip near the atrial wall. Differentiation of thrombosis from normal structure is possible with CT and, distinction of a thrombus from a tumor is possible on a delayed enhancement MRI with a long inversion time (500–600 ms). Granulocytic sarcoma of the heart is indicated by an infiltrative nature with involvement of whole layers of myocardium on CT and MRI. MRI with T2* mapping is useful in evaluating myocardial iron content in patients with hemochromatosis. Diffuse subendocardial enhancement is typically observed on delayed MRIs in patients with cardiac amyloidosis. T1 mapping is an emerging tool to diagnose amyloidosis. Myocardial abscess can occur due to an immunocompromised status. CT and MRI show loculated lesions with fluid density and concomitant rim-like contrast enhancement. Awareness of CT and MRI findings of cardiac complications of hematologic diseases can be helpful to physicians for clinical decision making and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Boersma RS, Jie KS, Verbon A et al (2008) Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies. Ann Oncol 19(3):433–442

    Article  CAS  PubMed  Google Scholar 

  2. Cortelezzia A, Fracchiolla NS, Maisonneuve P et al (2003) Central venous catheter-related complications in patients with hematological malignancies: a retrospective analysis of risk factors and prophylactic measures. Leuk Lymphoma 44(9):1495–1501

    Article  CAS  PubMed  Google Scholar 

  3. Elice F, Rodeghiero F (2012) Hematologic malignancies and thrombosis. Thromb Res 129(3):360–366

    Article  CAS  PubMed  Google Scholar 

  4. Worth LJ, Seymour JF, Slavin MA (2009) Infective and thrombotic complications of central venous catheters in patients with hematological malignancy: prospective evaluation of nontunneled devices. Support Care Cancer 17(7):811–818

    Article  PubMed  Google Scholar 

  5. van Rooden CJ, Schippers EF, Barge RM et al (2005) Infectious complications of central venous catheters increase the risk of catheter-related thrombosis in hematology patients: a prospective study. J Clin Oncol 23(12):2655–2660

    Article  PubMed  Google Scholar 

  6. Tan CH, Pua U, Chia PL (2009) Multidetector row CT diagnosis of an infected right atrial thrombus following repeated dialysis catheter placement. Br J Radiol 82(984):e240–e242

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Burns KE, McLaren A (2009) Catheter-related right atrial thrombus and pulmonary embolism: a case report and systematic review of the literature. Can Respir J 16(5):163–165

    PubMed Central  PubMed  Google Scholar 

  8. Ram R, Swarnalatha G, Rakesh Y et al (2009) Right atrial thrombus due to internal jugular vein catheter. Hemodial Int 13(3):261–265

    Article  PubMed  Google Scholar 

  9. Buckley O, Madan R, Kwong R et al (2011) Cardiac masses, part 1: imaging strategies and technical considerations. AJR Am J Roentgenol 197(5):W837–W841

    Article  PubMed Central  PubMed  Google Scholar 

  10. Spencer K, Weinert L, Pentz WH (1999) Calcified right atrial mass in a woman receiving long-term intravenous phosphate therapy. J Am Soc Echocardiogr 12(3):215–217

    Article  CAS  PubMed  Google Scholar 

  11. Watts MA, Innes BJ (1984) Calcified atrial thrombus: complication of central venous hyperalimentation. Tex Heart Inst J 11(1):76–79

    PubMed Central  CAS  PubMed  Google Scholar 

  12. Tsai MH, Yang CP, Chung HT et al (2009) Acute myeloid leukemia in a young girl presenting with mediastinal granulocytic sarcoma invading pericardium and causing superior vena cava syndrome. J Pediatr Hematol Oncol 31(12):980–982

    Article  PubMed  Google Scholar 

  13. Mignano JE, Chan MD, Rosenwald IB et al (2009) Intracardiac chloroma. J Pediatr Hematol Oncol 31(12):977–979

    Article  PubMed  Google Scholar 

  14. Neiman RS, Barcos M, Berard C et al (1981) Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer 48(6):1426–1437

    Article  CAS  PubMed  Google Scholar 

  15. Guermazi A, Feger C, Rousselot P et al (2002) Granulocytic sarcoma (chloroma): imaging findings in adults and children. AJR Am J Roentgenol 178(2):319–325

    Article  CAS  PubMed  Google Scholar 

  16. Rigamonti F, Beris P, Sanchez-Pareja A et al (2009) Atypical presentation of acute myeloid leukemia: cardiac myeloid sarcoma. Int J Hematol 89(5):693–698

    Article  PubMed  Google Scholar 

  17. Tsai J, Lee EY (2010) MDCT imaging findings of extramedullary granulocytic sarcoma of the heart. J Thorac Imaging 25(1):W14–W16

    Article  PubMed  Google Scholar 

  18. Cash T, Becton D, Mian A (2011) Cardiac myeloid sarcoma: a case report and review of literature. J Pediatr Hematol Oncol 33(7):e330–e332

    Article  PubMed  Google Scholar 

  19. Makaryus AN, Tung F, Liu W et al (2003) Extensive neoplastic cardiac infiltration in a patient with acute myelogenous leukemia: role of echocardiography. Echocardiography 20(6):539–544

    Article  PubMed  Google Scholar 

  20. Roberts WC, Bodey GP, Wertlake PT (1968) The heart in acute leukemia. A study of 420 autopsy cases. Am J Cardiol 21(3):388–412

    Article  CAS  PubMed  Google Scholar 

  21. Kara IO, Sahin B, Paydas S et al (2005) Granulocytic sarcoma of the heart: extramedullary relapse of acute myeloblastic leukemia after allogeneic stem cell transplantation successfully treated by chemotherapy alone. Leuk Lymphoma 46(7):1081–1084

    Article  PubMed  Google Scholar 

  22. Marcos-Alberca P, Ibanez B, Rey M et al (2004) Cardiac granulocytic sarcoma (chloroma): in vivo diagnosis with transesophageal echocardiography. J Am Soc Echocardiogr 17(9):1000–1002

    Article  PubMed  Google Scholar 

  23. Attallah A, Cheong BY, Bernicker E et al (2010) Cardiac chloroma: novel presentation and subsequent diagnosis with cardiac magnetic resonance imaging. Tex Heart Inst J 37(2):242–243

    PubMed Central  PubMed  Google Scholar 

  24. Anderson LJ, Holden S, Davis B et al (2001) Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 22(23):2171–2179

    Article  CAS  PubMed  Google Scholar 

  25. Wood JC, Noetzli L (2010) Cardiovascular MRI in thalassemia major. Ann N Y Acad Sci 1202:173–179

    Article  PubMed  Google Scholar 

  26. Penugonda N (2010) Cardiac MRI in infiltrative disorders: a concise review. Curr Cardiol Rev 6(2):134–136

    Article  PubMed Central  PubMed  Google Scholar 

  27. Meloni A, Positano V, Keilberg P et al (2012) Feasibility, reproducibility, and reliability for the T*2 iron evaluation at 3 T in comparison with 1.5 T. Magn Reson Med 68(2):543–551

    Article  CAS  PubMed  Google Scholar 

  28. Madan S, Dispenzieri A, Lacy MQ et al (2010) Clinical features and treatment response of light chain (AL) amyloidosis diagnosed in patients with previous diagnosis of multiple myeloma. Mayo Clin Proc 85(3):232–238

    Article  PubMed Central  PubMed  Google Scholar 

  29. Martinelli N, Carleo P, Girelli D et al (2011) An unusual heart failure: cardiac amyloidosis due to light-chain myeloma. Circulation 123(18):e583–e584

    Article  PubMed  Google Scholar 

  30. Sedaghat D, Zakir RM, Choe J et al (2009) Cardiac amyloidosis in a patient with multiple myeloma: a case report and review of literature. J Clin Ultrasound 37(3):179–184

    Article  PubMed  Google Scholar 

  31. Krombach GA, Hahn C, Tomars M et al (2007) Cardiac amyloidosis: MR imaging findings and T1 quantification, comparison with control subjects. J Magn Reson Imaging 25(6):1283–1287

    Article  PubMed  Google Scholar 

  32. Rahman JE, Helou EF, Gelzer-Bell R et al (2004) Noninvasive diagnosis of biopsy-proven cardiac amyloidosis. J Am Coll Cardiol 43(3):410–415

    Article  PubMed  Google Scholar 

  33. vanden Driesen RI, Slaughter RE, Strugnell WE (2006) MR findings in cardiac amyloidosis. AJR Am J Roentgenol 186(6):1682–1685

    Article  Google Scholar 

  34. Soler R, Rodriguez E, Remuinan C et al (2003) Magnetic resonance imaging of primary cardiomyopathies. J Comput Assist Tomogr 27(5):724–734

    Article  PubMed  Google Scholar 

  35. Robbers LF, Baars EN, Brouwer WP et al (2012) T1 mapping shows increased extracellular matrix size in the myocardium due to amyloid depositions. Circ Cardiovasc Imaging 5(3):423–426

    Article  PubMed  Google Scholar 

  36. Lee JJ, Liu S, Nacif MS et al (2011) Myocardial T1 and extracellular volume fraction mapping at 3 tesla. J Cardiovasc Magn Reson 13:75

    Article  PubMed Central  PubMed  Google Scholar 

  37. Karamitsos TD, Piechnik SK, Banypersad SM et al (2013) Noncontrast T1 mapping for the diagnosis of cardiac amyloidosis. JACC Cardiovasc Imaging 6(4):488–497

    Article  PubMed  Google Scholar 

  38. Kang WY, Kim SS, Kim HK et al (2009) A case of myocardial abscess mimicking acute myocardial infarction. J Cardiovasc Ultrasound 17(2):73–75

    Article  Google Scholar 

  39. Kemdem A, Ahmad I, Ysebrand L et al (2008) An Aspergillus myocardial abscess diagnosed by echocardiography. J Am Soc Echocardiogr 21(10):e1173–e1175

    Article  Google Scholar 

  40. Buja LM, Ferrans VJ, Graw RG Jr (1976) Cardiac pathologic findings in patients treated with bone marrow transplantation. Hum Pathol 7(1):17–45

    Article  CAS  PubMed  Google Scholar 

  41. Al Soub H, Al Maslamani M, Al Khuwaiter J et al (2009) Myocardial abscess and bacteremia complicating Mycobacterium fortuitum pacemaker infection: case report and review of the literature. Pediatr Infect Dis J 28(11):1032–1034

    Article  PubMed  Google Scholar 

  42. Iqbal J, Ahmed I, Baig W (2008) Metastatic myocardial abscess on the posterior wall of the left ventricle: a case report. J Med Case Rep 2:258

    Article  PubMed Central  PubMed  Google Scholar 

  43. Chikwe J, Barnard J, Pepper JR (2004) Myocardial abscess. Heart 90(6):597

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  44. Walker N, Bhan A, Desai J et al (2010) Myocardial abscess: a rare complication of valvular endocarditis demonstrated by 3D contrast echocardiography. Eur J Echocardiogr 11(10):E37

    Article  PubMed  Google Scholar 

  45. Chakrabarti J (1995) Diagnostic evaluation of myocardial abscesses. A new look at an old problem. Int J Cardiol 52(3):189–196

    Article  CAS  PubMed  Google Scholar 

  46. Hill EE, Herijgers P, Claus P et al (2007) Abscess in infective endocarditis: the value of transesophageal echocardiography and outcome: a 5-year study. Am Heart J 154(5):923–928

    Article  PubMed  Google Scholar 

  47. Reynier C, Garcier J, Legault B et al (2001) Cross-sectional imaging of post endocarditis paravalvular myocardial abscesses of native mitral valves: 4 cases. J Radiol 82(6 Pt 1):665–669

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Departments of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea

    Tae Yun Kim, Jung Im Jung & Hae Giu Lee

  2. Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Yoo Jin Kim

  3. Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Hwan Wook Kim

Authors
  1. Tae Yun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jung Im Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoo Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hwan Wook Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hae Giu Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jung Im Jung.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, T.Y., Jung, J.I., Kim, Y.J. et al. CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review. Int J Cardiovasc Imaging 31 (Suppl 2), 159–167 (2015). https://doi.org/10.1007/s10554-015-0610-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-015-0610-5

Keywords

Search

Navigation