This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Di Bella, G. Articles by Bogaert, J. Search for Related Content PubMed PubMed Citation Articles by Di Bella, G. Articles by Bogaert, J. Related Collections CT and MRI CV surgery: valvular disease

(Circulation. 2008;117:e292-e294.)
© 2008 American Heart Association, Inc.

Images in Cardiovascular Medicine

Liquefaction Necrosis of Mitral Annulus Calcification

Detection and Characterization With Cardiac Magnetic Resonance Imaging

Gianluca Di Bella, MD; Pier Giorgi Masci, MD; Javier Ganame, MD; Steven Dymarkowski, MD, PhD; Jan Bogaert, MD, PhD

From the Medical Imaging Centre, UZ Leuven, Leuven, Belgium.

Correspondence to Jan Bogaert, MD, PhD, Medical Imaging Centre, UZ Leuven, Herestraat 49, B-3000 Leuven, Belgium. E-mail Jan.Bogaert@uz. kuleuven.ac.be

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A transthoracic echocardiogram of a 68-year-old man complaining of exercise-related retrosternal chest pain revealed a dense, echogenic, calcified nodular structure at the posterior side of the mitral valve annulus (Figure 1). The patient was referred for cardiac magnetic resonance imaging (MRI). T1-weighted fast spin-echo (FSE) (Figure 2A) showed a well-defined structure (28 mm in diameter) with a homogeneous, slightly hyperintense center and a hypointense rim (Figure 2A, arrows) located between the posterior mitral valve leaflet and adjacent left ventricular myocardium. Fat suppression did not alter signal characteristics (Figure 2B, arrows). On T2 short- inversion-recovery FSE, the structure was devoid of signal (Figure 2C, arrows). Dynamic imaging using steady-state free-precession cine MRI in the horizontal long-axis plane (Figure 2D and Movie I) and in the short-axis plane (Figure 3A and Movie II) obtained through the mitral valve plane showed a non- or at most minimally deforming mass moving in synchronicity with the surrounding left ventricular myocardium (arrows) and presence of moderately severe mitral regurgitation (Figure 2D, black arrowheads, and Movie I). Myocardial perfusion MRI in the horizontal long-axis (Movie III) showed a hyperintense appearance of the structure before contrast administration but no evidence of enhancement during the first pass. Although FSE after contrast administration (Figure 2E, arrows) did not show enhancement, strong peripheral enhancement was found 10 minutes after contrast administration with the use of the contrast-enhanced inversion-recovery technique (Figure 2F, . . . [Full Text of this Article]

This article has been cited by other articles:

				Y. T. SIA, D. Dulay, I. G. Burwash, L. M. Beauchesne, K. Ascah, and K. L. Chan Mobile ventricular thrombus arising from the mitral annulus in patients with dense mitral annular calcification Eur J Echocardiogr, November 17, 2009; (2009) jep181v1. [Abstract] [Full Text] [PDF]