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

2002; Elsevier BV; Volume: 89; Issue: 10 Linguagem: Inglês

10.1016/s0002-9149(02)02314-7

1879-1913

Maria Kiaffas, Andrew J. Powell, Tal Geva,

Eosinophilic Disorders and Syndromes

Primary cardiac tumors are rare in childhood, with a reported incidence of 0.0017% to 0.027% based on postmortem studies. 1 Straus R. Merliss R. Primary tumors of the heart. Arch Path. 1945; 39: 74-78 Google Scholar , 2 Nadas A.S. Ellison R.C. Cardiac tumors in infancy. Am J Cardiol. 1968; 21: 363-366 Abstract Full Text PDF PubMed Scopus (255) Google Scholar 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. 3 Freedom R.M. Lee K.J. MacDonald C. Taylor G. Selected aspects of cardiac tumors in infancy and childhood. Pediatr Cardiol. 2000; 2: 299-316 Crossref Scopus (173) Google Scholar 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. 3 Freedom R.M. Lee K.J. MacDonald C. Taylor G. Selected aspects of cardiac tumors in infancy and childhood. Pediatr Cardiol. 2000; 2: 299-316 Crossref Scopus (173) Google Scholar , 4 Beghetti M. Gow R.M. Haney I. Mawson J. Williams W. Freedom R. Pediatric primary benign cardiac tumors a 15-year review. Am Heart J. 1997; 134: 1107-1114 Abstract Full Text Full Text PDF PubMed Scopus (281) Google Scholar , 5 Sallee D. Spector M.L. van Heeckeren D.W. Patel C.R. Primary pediatric cardiac tumors a 17 year experience. Cardiol Young. 1999; 9: 155-162 Crossref PubMed Google Scholar , 6 Becker A.E. Primary heart tumors in the pediatric age group a review of salient pathologic features relevant for clinicians. Pediatr Cardiol. 2000; 2: 317-323 Crossref Scopus (156) Google Scholar Its echocardiographic features are well established and additional cardiac imaging tests are seldom required for patient management. 4 Beghetti M. Gow R.M. Haney I. Mawson J. Williams W. Freedom R. Pediatric primary benign cardiac tumors a 15-year review. Am Heart J. 1997; 134: 1107-1114 Abstract Full Text Full Text PDF PubMed Scopus (281) Google Scholar , 5 Sallee D. Spector M.L. van Heeckeren D.W. Patel C.R. Primary pediatric cardiac tumors a 17 year experience. Cardiol Young. 1999; 9: 155-162 Crossref PubMed Google Scholar 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. 7 Amparo E.G. Higgins C.B. Farmer D. Gamsu G. Mcnamara M. Gated-MRI of cardiac and paracardiac masses initial experience. Am J Roentgenol. 1984; 143: 1151-1156 Crossref PubMed Scopus (111) Google Scholar , 8 Lund J.T. Ehman R.L. Julsrud P.R. Sinak L.J. Tajik A.J. Cardiac masses assessment by MR imaging. Am J Roentgenol. 1989; 152: 469-473 Crossref PubMed Scopus (159) Google Scholar However, only a few studies on MRI evaluation of cardiac tumors include infants and children. 7 Amparo E.G. Higgins C.B. Farmer D. Gamsu G. Mcnamara M. Gated-MRI of cardiac and paracardiac masses initial experience. Am J Roentgenol. 1984; 143: 1151-1156 Crossref PubMed Scopus (111) Google Scholar , 8 Lund J.T. Ehman R.L. Julsrud P.R. Sinak L.J. Tajik A.J. Cardiac masses assessment by MR imaging. Am J Roentgenol. 1989; 152: 469-473 Crossref PubMed Scopus (159) Google Scholar , 9 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. Am J Cardiol. 1985; 56: 831-832 Abstract Full Text PDF PubMed Scopus (25) Google Scholar , 10 Wann L.S. Sampson C. Liu Y. Cardiac and paracardiac masses complementary role of echocardiography and magnetic resonance imaging. Echocardiography. 1998; 15: 139-146 Crossref PubMed Scopus (16) Google Scholar 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.