case_images: PMC11771713_01
case_images: Case 1. The images show a thrombus in the right ventricle. Echocardiography, showed a striated mass in the right ventricle (A); CT enhancement scan, the right ventricle can be seen classified round filling defect (B); arterial iodine map, the patient's lesion arterial iodine concentration of 0.3 mg/mL (D); the effective atomic number map, the patient's lesion Zeff is 8.34 HU/Z (E); the energy spectral curve schematic diagram, the value of lambdaHu is 1.6 (F). Improved cardiac function, after anticoagulation, symptomatic treatment for 15 days and follow-up examination CTA of pulmonary artery: CTA of pulmonary artery did not show any abnormality, and there was no obvious abnormal density shadow in the right ventricle (C).
case_images: medi-104-e41303-g001.jpg
case_images: PMC11771713_01_medi-104-e41303-g001.jpg
case_images: F1
case_images: The results of the echocardiography revealed a striated mass in the right ventricle (Fig. 1A); the CT enhancement scan showed a classified round filling defect in the right ventricle (Fig. 1B); the arterial iodine map showed a 0.3 mg/ml concentration of the patient's lesion (Fig. 1D); the effective atomic number map revealed that the patient's lesion Z effective (Zeff) is 8.34HU/Z (Fig. 1E); and the energy spectral curve schematic diagram showed that the value of lambdaHu is 1.6 (Fig. 1F). After therapy and follow-up, the floating thrombus in the right ventricle was verified to be the cause of the absence of any evident aberrant density shadow in the pulmonary artery CTA (Fig. 1C). Additionally, more follow-up results are shown in Figure S1, Supplemental Digital Content, http://links.lww.com/MD/O289, as evidence further supported the diagnosis of thrombosis in this case.
case_images: PMC11771713_02
case_images: Case 2. The images show a thrombus in the right atrium. Echocardiography showed an isoechoic mass in the right atrium, measuring about 15.36 x 17.45 mm (A); CT enhancement scan indicated a classically round filling defect in the right atrium (B); The arterial-phase iodine map showed the arterial-phase iodine concentration in the lesion of the patient in the present case was 0.6 mg/mL (D); The effective atomic number map shown the lesion of the patient in the present case had a Zeff of 8.15 HU/Z (E); and the energy spectrum curve was schematic, with lambdaHu being valued as 1.1 (E). After 2 months of anticoagulation therapy, the echocardiogram was repeated, and no abnormal echoes were seen in the chambers of the heart (C).
case_images: medi-104-e41303-g002.jpg
case_images: PMC11771713_02_medi-104-e41303-g002.jpg
case_images: F2
case_images: The echocardiography showed an isoechoic mass in the right atrium, measuring about 15.36 mm x 17.45 mm (Fig. 2A); the CT enhancement scan indicated a classically round filling defect in the right atrium (Fig. 2B); the arterial-phase iodine map demonstrated arterial-phase iodine concentration in the lesion of the patient in the present case was 0.6 mg/mL (Fig. 2D); the effective atomic number map showed the lesion of the patient in the present case had a Zeff of 8.15 HU/Z (Fig. 2E); and the energy spectrum curve was schematic, with lambdaHu being valued as 1.1 (Fig. 2F). Echocardiography was reviewed after 2 months of anticoagulation therapy, and no abnormal echoes were found in the chambers of the heart (Fig. 2C), which confirmed the right atrial thrombosis case by the follow-up of treatment. As shown in the follow-up results of ultrasound (Figure S2, Supplemental Digital Content, http://links.lww.com/MD/O289),the disappearance of the right atrial mass is considered evidence for diagnosing thrombus.
case_images: PMC11771713_03
case_images: Case 3. The images show a myxoma in the right ventricle. Echocardiography, right ventricular free wall heterogeneous echogenic mass, lobulated, suggestive of right ventricular free wall mass (A); CT enhancement scan, right ventricle can be seen in a class of rounded low-density shadows, the edge of the arc-shaped calcification (B); MRI enhancement examination shows that the right ventricular free wall mass-like enhancement shadows, the edge of the visible line-like non-enhanced area, the lesion and the right ventricular free wall wide base is connected to the consideration of the possibility of myxoma (C). The arterial iodine concentration of the lesion was 2.8 mg/mL in the arterial iodine map (D); the effective atomic number map showed that the Zeff of the lesion was 9.10 HU/Z (E); and the lambdaHu of the energy spectrum curve showed that the lambdaHu was 2.9 (F).
case_images: medi-104-e41303-g003.jpg
case_images: PMC11771713_03_medi-104-e41303-g003.jpg
case_images: F3
case_images: The echocardiography suggested a right ventricular free wall heterogeneous echogenic mass, which looked lobulated, and suggestive of right ventricular free wall mass (Fig. 3A). From the CT enhancement scan, the right ventricle could be seen in a class of rounded low-density shadows, the edge of the arc-shaped calcification (Fig. 3B); MRI enhancement examination showed that the right ventricular free wall mass-like enhancement shadows, the edge of the visible line-like non-enhanced area, the lesion and the right ventricular free wall wide base were connected to the consideration of the possibility of myxoma (Fig. 3C). The arterial iodine concentration of the lesion was 2.8 mg/mL in the arterial iodine map (Fig. 3D); the effective atomic number map showed that the Zeff of the lesion was 9.10 HU/Z (Fig. 3E); and lambdaHu of the energy spectrum curve showed that the value of lambdaHu was 2.9 (Fig. 3F). In addition, more detailed follow-up information is shown in Figure S3, Supplemental Digital Content, http://links.lww.com/MD/O289.