Multimodality imaging of a right atrial blood cyst
Bibliographic record
Abstract
A right atrial intracardiac mass was incidentally discovered on abdominopelvic computed tomography imaging in a healthy 62-year-old woman (Panel A). Other than chronic back pain, she was asymptomatic, denying constitutional symptoms, chest pain, dyspnoea, palpitations, nor syncope. She denied any history of bleeding or clotting diatheses. Transthoracic and transoesophageal echocardiography confirmed the presence of a large cyst-like structure within the right atrium (Panels B and C, see Supplementary material online, Videos S1B and C). In the right ventricular inflow view, it measured 45 mm × 54 mm in dimension and was tethered to the tricuspid valve leaflets with evidence of moderate tricuspid regurgitation (Panels B and C, see Supplementary material online, Videos S1B and C). Cardiac magnetic resonance imaging confirmed the large intracardiac mobile mass within a dilated right atrium prolapsing across the tricuspid valve (Panel D, see Supplementary material online, Video S1D). The right atrial mass demonstrated low signal intensity on T1- and T2-weighted imaging with no evidence of delayed enhancement (Panel E). At the time of cardio-pulmonary bypass surgery, a right atriotomy confirmed a large cystic right atrial mass with an air–fluid interface consistent with an intracardiac blood cyst (Panel F, see Supplementary material online, Video S1F). The diagnosis of a right atrial blood cyst (3.7 g; 4.5 × 5.5 cm in diameter) was confirmed on pathology. Blood cysts are exceedingly rare in adults, representing 1.5% of intracardiac tumours. They are benign tumours, often arising from the atrioventricular valves that may lead to syncope, embolism, valvular dysfunction, and/or death. Following characterization of an atrial blood cyst using multimodality cardiac imaging, surgical resection to prevent emboli and exclude malignancy is recommended. RV, right ventricle; LA, left atrium; LV, left ventricle; RA, right atrium. Supplementary material is available at European Heart Journal online.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| 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".