Herztumoren: Magnetresonanztomographie und Mehrschicht-Spiral-CT

Zusammenfassung

Die Untersuchung bei Verdacht auf Herztumoren ist zunächst die Domäne der Echokardiographie. Diese Methode ist jedoch durch ihr begrenztes Messfeld und das bei manchen Patienten unzureichende Schallfenster eingeschränkt. Die Magnetresonanztomographie (MRT) und seit Einführung der Mehrschicht-Spiralcomputertomographie (MSCT) auch dieses Verfahren erlauben die detaillierte Darstellung von intra- und parakardialen Tumoren sowie die Bestimmung ihrer Ausdehnung und ihres Einflusses auf die Herzfunktion. Primäre benigne und maligne Herztumoren weisen in der MRT einige charakteristische Merkmale auf, die die Differenzialdiagnose erheblich einengen und in manchen Fällen die eindeutige Diagnose erlauben. Viele dieser Merkmale werden auch in der Computertomographie (CT) deutlich. Die vorliegende Arbeit gibt einen Überblick über Untersuchungstechniken in den Schnittbildverfahren MRT und CT bei Verdacht auf eine kardiale Raumforderung und beschreibt das Erscheinungsbild von primären und sekundären Herztumoren und intrakardialen Thromben.

Abstract

Transthoracic echocardiography is usually the initial diagnostic test in patients with a suspected cardiac mass. However, this technique is restricted by its small field of views and insufficient acoustic window in some patients. Magnetic resonance imaging (MRI) and, since its introduction, multislice spiral computed tomography allow for detailed delineation of intra and pericardiac tumors, their extent, and their influence on cardiac function. Primary benign and malignant cardiac tumors have several characteristic features in MR imaging. Assessment of such features may narrow down the differential diagnosis or even allow for reliable diagnosis in selected cases. Many such features can also be assessed using MSCT. This article provides an overview of examination protocols of MRI and CT for cases in which a cardiac mass is suspected and describes the appearance of primary and secondary cardiac masses as well as intracavitary thrombi.

Key words

Cardiac masses - MRI, heart

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