Prominent Crista Terminalis Magnetic Resonance Imaging Findings

Yıl 2023, Cilt: 7 Sayı: 2, 565 - 572, 31.05.2023

Sedat Altay

https://doi.org/10.30621/jbachs.904705

Öz

Purpose: Prominent Crista Terminalis (PCT) is a frequent variation of the right atrium (RA) posterior wall with a pseudotumor image. The aim of this study is to evaluate PCT image characteristics and cardiac functional effects with cardiac magnetic resonance imaging (CMR).
Methods: Between 2016 and 2020, 140 patients (58 ±14 years) were evaluated retrospectively. PCT was measured in 2 planes with the longest thickness at the atrial end-diastole. Patients with crista terminalis thickness greater than 8 mm were evaluated. Patients were assessed by the RA, right ventricular (RV) end-diastolic diameter (ED), RV, left ventriculi (LV) ejection fraction (EF), and PCT diameter were included in the study. After the Kolmogorov-Smirnov normality test, cases were compared with the paired student t-test. Mann-Whitney test was used for comparison of non-parametric variables. The effect of the increase in PCT diameter on the RVEF, LVEF, and RAED, RVED was investigated using Pearson's correlation coefficient.
Results: There was no significant correlation (r<0,5) between PCT thickness and RVEF (r=0.49), LVEF (r=0,115), RAED (r=0.32), RVED (r=0.07). Fourteen patients (10%) with PCT had a history of arrhythmia. Arrhythmia was not observed in patients with PCT less than 10 mm. It was observed that the risk of arrhythmia increased with PCT thickness.
Conclusion: CMR image features provided reliable data for patient management in PCT diagnosis and follow-up. There was not detected statically significant change in right and left heart functions in patients with PCT. It was observed that there was a relationship between arrhythmia incidence and PCT dimension in patients.

Anahtar Kelimeler

Crista Terminalis, Right Atrial Mass, Anatomical Variants, Imaging Pitfalls, Cardiac Magnetic Resonance

Kaynakça

• Referans1. Salim H, Palit A, Maher A. When is a mass not a mass? An unusual presentation of prominent crista terminalis. BMJ Case Rep 2016;bcr2015211532.
• Referans2. Pharr JR, Figueredo VM. Lipomatous hypertrophy of the atrial septum and prominent crista terminalis appearing as a right atrial mass. Eur J Echocardiogr 2002;3:159‐161.
• Referans3. Wang J, Wang G, Bi X, Zhang R, Liu C. An unusual presentation of prominent crista terminalis mimicking a right atrial mass: a case report. BMC Cardiovasc Disord 2018;18:210.