Résumé
Les tumeurs cardiaques bénignes et malignes sont rares. L’imagerie en général et l’échographie cardiaque en particulier ont une place centrale dans le diagnostic positif et différentiel, l’évaluation du retentissement et la prise en charge d’une masse ou tumeur cardiaque. Largement diffusée, non irradiante cette technique constitue la première étape dans la démarche diagnostique. L’objectif de l’échographie cardiaque est de permettre une meilleure caractérisation tissulaire, de décrire l’implantation, l’extension et le retentissement de la masse. Elle est complétée par une échographie de contraste permettant de préciser le degré de vascularisation de la masse et par une échographie transoesophagienne couplée à une acquisition tridimensionnelle. L’IRM cardiaque et le scanner cardiaque viennent compléter avantageusement cette démarche en fournissant de nombreuses informations notamment concernant la caractérisation tissulaire. En pratique clinique, la principale difficulté reste de distinguer et d’assurer le diagnostic différentiel et positif entre les pseudotumeurs (thrombus, végétation), les variantes anatomiques et tumeurs primitives et secondaires.
Abstract
Primary tumors are a rare phenomenon, while cardiac metastasis is rather more frequent. Cardiac masses and metastasis are usually first detected by echocardiography, which allows to describe and detail the size, the insertion, the mobility, the relation with cardiac and non-cardiac structure, and local invasion. Myocardial contrast echocardiography is able to improve tissue characterization of the masses. Transthoracic echocardiography evaluation is generally completed by cardiac magnetic resonance and computed tomography scanner, which give some important and additional information on tissue characteristics and tissue property such as vascularity and fibrosis.
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Ederhy, S., Soulat-Dufour, L., Ileana, E. et al. Apport de l’imagerie dans l’évaluation des masses et métastases cardiaques. Oncologie 16, 233–238 (2014). https://doi.org/10.1007/s10269-014-2394-y
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DOI: https://doi.org/10.1007/s10269-014-2394-y