PMC3863965_01
Transthoracic echocardiographic: apical four-chamber view (a), parasternal long axis (b), and short axis (c) views: showing an echodense, spherical, tumor-like mass located in the region of posterior mitral annulus (arrowheads), with a heterogeneous central area (arrow). Note that acoustic shadowing artifacts behind the calcification are absent. Ao, aorta; LA, left atrium; LV, left ventricle; MV, mitral valve.
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An 82-year-old woman with a history of high blood pressure and hyperlipidemia underwent a routine transthoracic echocardiography (Fig. 1) which showed a large hyperechogenic mass, located at the posterior side of the mitral valve annulus and not associated to valvular dysfunction.
MDCT in axial (a, b) and four-chamber (c, d) views after injection of contrast: a hyperdense mass with hypodense unenhanced center and a calcified peripheral rim located at the anterior and posterior side of the mitral valve annulus. The four-chamber view shows the crescent-shaped dense mass.
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An atrial mass was suspected and to better evaluate this mass, a MDCT was performed (Figs. 2 -4), showing a hyperdense mass with hypodense center and a calcified peripheral rim located at the anterior and posterior mitral ring.
MDCT, long axis (a), short axis (b), and two-chamber (c) views: a tumor-like mass with a hypodense central area and peripheral dense calcification in the mitral valve annulus. Short-axis view (b) shows heterogeneity of the caseous calcification; this is confirmed by widely varying densities, including low attenuation value indicating fatty degeneration, as well as very high values indicating dense calcifications. Two-chamber view of the mass (c) demonstrates the close relation to the mitral valve.
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An atrial mass was suspected and to better evaluate this mass, a MDCT was performed (Figs. 2 -4), showing a hyperdense mass with hypodense center and a calcified peripheral rim located at the anterior and posterior mitral ring.
Volume-rendered CT image (a) shows the caseous calcification in the periannular region of the mitral valve (arrow). Coronal view of the caseous calcification, with maximum intensity projection reconstruction (MIP) (b).
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An atrial mass was suspected and to better evaluate this mass, a MDCT was performed (Figs. 2 -4), showing a hyperdense mass with hypodense center and a calcified peripheral rim located at the anterior and posterior mitral ring.