Cardiac masses are divided into neoplastic and non‐neoplastic. They usually represent a diagnostic challenge given their relative rarity, their infrequent symptoms, and the overall difficulty with dynamic imaging of the heart. While echocardiography is useful in the initial evaluation of a suspected mass, cardiac magnetic resonance (CMR) imaging is the best imaging modality to characterize cardiac tumors due to its superior tissue characterization and its higher contrast resolution. For neoplastic, primary cardiac tumors are rare (0.05%). Atrial myxoma is the most common cardiac (50%) mass. About 75%‐80% of myxoma are seen in the left atrium. Atypical myxoma is a term describing myxoma arising in other nonleft atrial locations. 20%‐25% myxomas arise from the right atrium and 5% or less from the ventricles. We present a case of a 59‐year‐old female patient presenting with severe dyspnea. Her chest noncontrast CT showed a calcified mass lesion in the right atrium extending into the inferior vena cava. She underwent cardiac MRI for better tissue characterization. The cardiac MRI revealed a very irregular, highly spiculated, heavily calcified, heterogeneous, and nonenhancing lesion within the right atrium extending into the inferior vena cava. Via dynamic imaging, no evidence of mobile components was present. Via T1, T2 along with pre‐ and postcontrast imaging, the mass was confirmed to be calcified without a fibrotic component or evidence of thrombus. The above findings raised the possibility of atypical myxoma.
Magnetic Resonance Spectroscopy (MRS) is used in diagnostic imaging for disease metabolism evaluation. The H MRS is highly used because of the abundance, high sensitivity, etc. The various clinical implementation includes whole-brain MRS is used in measuring metabolites of different brain areas simultaneously. The breast MRS is used in malignant and benign tumors differentiation by the total choline compound. The prostate MRS is used to map the metabolites like citrate, choline, and creatinine. For spinal cord MRS, the myoinositol and N acetyl aspartate were 31 23 1 considered markers for various diseases. The MRS uses nuclei like P, Na, and H for metabolic and biochemical evaluation of cardiac muscles. The liver MRS spectrum has mainly methylene group of lipid, methyl groups of choline, and water. The MRS measures choline, creatinine, lactate, and lipid peaks in uterine leiomyoma and myometrium. Hence there are organ-specic metabolites used as a reference to map the metabolic process by using spectroscopy, making it one of the commonly preferred technique.
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