Echodensity of mitral valve mass

 Q: A low density of mechanical mitral valve mass on echocardiogram favors? (select one)

A) Thrombus

B) Pannus

Answer: A

Echodensity can be described in two ways:

1. Qualitatively - 

• low intensity: similar to myocardial echodensity
• high-intensity: similar to the prosthetic hardware echodensity

 2. Quantitatively -

It is described as using the ratio of the intensity of mass/intensity of prosthesis. A low-intensity mass of ≤0.45 suggests a presumptive diagnosis of thrombus. 

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References:

1. Barbetseas J, Nagueh SF, Pitsavos C, et al. Differentiating thrombus from pannus formation in obstructed mechanical prosthetic valves: an evaluation of clinical, transthoracic and transesophageal echocardiographic parameters. J Am Coll Cardiol 1998; 32:1410. 

2. Lin SS, Tiong IY, Asher CR, et al. Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography. Am J Cardiol 2000; 86:1097.