Journal of Cardiovascular Computed Tomography (2008) 2, 197-198

Cardiac multidetector computed tomography incidental finding of a membranous septal aneurysm

Alexandre C. Ferreira, MD, FACCab, Yasser Rodrigue, BS, Joel E. Fishman, MD, PhD, Eduard Ghersin, MD

A 48-year-old woman was referred for the evaluation of an ongoing history of chest pain despite prior negative evaluations. An electrocardiographic-gated multidetector computed tomography (MDCT) study using a 64-slice scan-ner was performed. No coronary artery calcifications or obstructive lesions were observed. However, investigation of the chambers showed a membranous septal aneurysm with a patent lumen without intraluminal filling defects and which communicated with the left ventricular cavity through a widely patent neck. The wall of the membranous septal aneurysm showed low CT attenuation, suggesting fibrous tissue composition (Fig 1). Cine images showed no significant motion or contractility during the cardiac cycle and no evidence of right ventricular outflow obstruction. The aortic valve showed normal leaflet motion and coaptation (see sup-plementary material online at www.CardiacCTJournal.com). Cardiac MDCT with its high temporal, spatial, and con-trast resolutions and its multiplanar capabilities offers ac-curate dynamic evaluation of cardiac chambers and valves. In this case, the technique showed a membranous septal aneurysm, including its patent lumen and the tissue charac-ter of its wall. Multiplanar imaging also permitted the def-inition of its inferior location relative to the aortic valve, thus excluding other potential diagnoses, such as an aneu-rysm of the sinus of Valsalva.