CTICasesFocal Caseous Necrosis with Calcium of Mitral Valve Annulus
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Imaging findings
Contrast CT showed an attenuating item in the left atrium/ventricle, with attenuation similar to contrast medium. Non-contrast CT for comparison revealed that the item was calcified, with more calcium in its dependent portion compared to the upper portion.
Key takeaways
This is a nice example of focal caseous necrosis of the mitral valve annulus, which can present as a "milk of calcium" like fluid with dependent calcification, sometimes described as cheesy necrotic stuff.
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