Intra-myocardial left ventricular lipoma associated with non-compaction cardiomyopathy
Bibliographic record
Abstract
A 62-year-old asymptomatic man underwent a transthoracic echocardiogram in order to investigate non-specific lateral ST-T segment changes. The echocardiogram showed an echogenic mass in the apex of the left ventricle. Cardiac magnetic resonance imaging was performed and steady-state free precession sequences (Figure 1A and B, see Supplementary data online, Movies S1 and S2) showed a bright intra-myocardial lesion involving the anterior and lateral walls of the left ventricle extending from the base to apex, measuring 15.4 mL. The left ventricular dimensions (LVEDVI: 73 mL/m2; LVESVI: 30 mL/m2; LVSV: 71 mL) and function (LVEF: 58%) were normal (see Supplementary data online, Movies S1 and S2). There was mild aortic insufficiency with a regurgitation volume of 5 mL/beat. The mass was characterized by bright signal on proton density weighted images (Figure 1C) and a decrease in signal with fat suppression imaging (Figure 1D). Moreover, there was a low signal within the mass on T2-weighted images, similar to the signal from subcutaneous fat. Gadolinium contrast administration did not demonstrate any abnormal enhancement in the mass (Figure 1E pre-contrast and F post-contrast), confirming the diagnosis of an intra-myocardial ventricular lipoma. Interestingly, there was hypertrabeculation of the left ventricle with a non-compacted/compacted (NC/C) wall ratio of 3, compatible with diagnosis of non-compaction cardiomyopathy. We measured the NC/C ratio in the long-axis view (Figure 1B: NC black line, C white line) including the lipoma in the compacted myocardial thickness measurement. Lipoma occurs rarely within the heart accounting for 2.9% of primary cardiac tumours and only 25% are found within the myocardium. On the other hand, isolated non-compaction of the myocardium is an idiopathic form of cardiomyopathy due to intra-uterine arrest of myocardial compaction with the estimated prevalence of 0.05% in the general population. This is the first case of an intra-myocardial lipoma associated with left ventricular non-compaction cardiomyopathy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".