We report an 85-year-old woman with caseous calcification of mitral annulus (CCMA), a rare variant of mitral annular calcification with caseous degeneration, in which imaging findings were useful for elucidating the pathogenesis and diagnosis. Since the CCMA is considered to be benign, it is important for clinicians to differentiate CCMA from other cardiac masses using multi-modality imaging in order to avoid unnecessary surgery. To the best of our knowledge, there is a paucity of literature regarding cardiac magnetic resonance (CMR) parametric mapping, an emerging technique, for evaluating CCMA. In the present case, by using multi-modality imaging including CMR parametric mapping, we were able to characterize the abnormal structure at mitral annulus non-invasively, and diagnosed the structure as CCMA. CMR with parametric mapping may have a role in the identification and definition of cardiac masses including CCMA.
Caseous calcification of mitral annulus (CCMA) is a rare variant of mitral annular calcification, but is not infrequently encountered in daily practice. Multi-modality imaging including cardiac magnetic resonance is useful for the diagnosis of CCMA. Differential diagnosis of cardiac masses at the mitral annulus including CCMA is important, and clinicians need to know the multi-modality imaging findings related to CCMA.
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- Caseous calcification of the mitral annulus: case report and brief review.Eur Heart J Case Rep. 2018; 2: 1-5
- A rare case of spontaneously dissolved calcification of the mitral annulus: Caseous calcification of the mitral annulus.J Cardiol Cases. 2018; 17: 99-102
- Liquefaction necrosis of mitral annular calcification (LNMAC): review of pathology, prevalence, imaging and management: proposed diagnostic imaging criteria with detailed multi-modality and MRI image characterization.Int J Cardiovasc Imaging. 2012; 28: 1161-1171
- Serial cardiac magnetic resonance imaging of a rapidly progressing liquefaction necrosis of mitral annulus calcification associated with embolic stroke.Circulation. 2012; 125: 2792-2795
- Caseous calcification of the mitral annulus: a review.Clin Cardiol. 2013; 36: E27-E31
- Cardiovascular magnetic resonance features of caseous calcification of the mitral annulus.J Cardiovasc Magn Reson. 2008; 10: 25
- Images in cardiovascular medicine. Liquefaction necrosis of mitral annulus calcification: detection and characterization with cardiac magnetic resonance imaging.Circulation. 2008; 117: e292-e294
Published online: May 28, 2022
Accepted: April 28, 2022
Received in revised form: April 19, 2022
Received: February 14, 2022
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.