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Long-term echocardiographic evaluation of valvular lesions in a patient with nonbacterial thrombotic endocarditis associated with advanced uterine cancer Shinobu Yokoyama, AS, Hiroyuki Iwano, MD, PhD, FJCC, Satoshi Yamada, MD, PhD, FJCC, Mahito Takeda, MD, Sanae Kaga, BS, Masahiro Nakabachi, MS, Hisao Nishino, AS, Ayako Ichikawa, BS, Ayumu Abe, PhD, Kazunori Okada, PhD, Daisuke Murai, MD, Taichi Hayashi, MD, Mutsumi Nishida, PhD, Hitoshi Shibuya, Kaoru Kahata, MD, PhD, Chikara Shimizu, MD, PhD, Taisei Mikami, MD, PhD, FJCC, Hiroyuki Tsutsui, MD, PhD, FJCC Journal of Cardiology Cases Volume 14, Issue 3, Pages (September 2016) DOI: /j.jccase Copyright © 2016 Japanese College of Cardiology Terms and Conditions
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Fig. 1 T2-weighted (A) and gadolinium-enhanced (B) MRI showing a large tumor in the uterine endometrium (dashed circle) infiltrating into the myometrium (dual arrow) and several myomas in the uterus (asterisk). Fluid attenuated inversion recovery MRI showing high intensity area at right parietal cortex (C, circle) as well as small, scattered high intensity areas at bilateral white matter (D, arrows), indicating prior multiple cerebral infarctions. MRI, magnetic resonance imaging. Journal of Cardiology Cases , 82-86DOI: ( /j.jccase ) Copyright © 2016 Japanese College of Cardiology Terms and Conditions
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Fig. 2 Transthoracic echocardiograms before anticoagulation therapy. Two-dimensional images of parasternal long-axis view at mid diastole (A) and mid systole (B) and color Doppler image of the same view at mid systole (C) are presented. The masses on the anterior (A, arrow) and posterior (A, arrow head) leaflets looked like single mass at mid systole (B, arrow) which deformed with the mitral regurgitant flow in the left atrium (C). Journal of Cardiology Cases , 82-86DOI: ( /j.jccase ) Copyright © 2016 Japanese College of Cardiology Terms and Conditions
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Fig. 3 Two-dimensional (upper panels) and color Doppler (lower panels) echocardiographic images at baseline (A) and 7 days (B), 11 days (C), 17 days (D), 66 days (E), and 136 days (F) after the initiation of anticoagulation therapy. The arrows and arrow heads indicate the vegetation attached to the left-atrial side of the anterior mitral leaflet (AML) and that to the left-atrial side of the posterior mitral leaflet (PML), respectively. Posterior vegetation disappeared on the 17th day (D) and anterior one on the 66th day (E), which were sustained until the 136th day (F) when the anticoagulation therapy had been discontinued. Journal of Cardiology Cases , 82-86DOI: ( /j.jccase ) Copyright © 2016 Japanese College of Cardiology Terms and Conditions
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