Atrial myxoma demonstrated by cine gradient refocused echo magnetic resonance imaging

Abstract

A case of atrial myxoma presenting with syncope evaluated by echocardiography and MRI is described. Cine gradient-echo MRI demonstrated atrial myxoma as a very low signal intensity mass indicating the presence of haemosiderin.

The Case of the Disappearing Myxoma

“…Cardiac myxomas arise in the left atrium approximately 75% of the time, usually attaching to the inter-atrial septum at the border of the fossa ovalis. Although the MRI literature usually describes masses by their T1 and T2 weighted characteristics, some recent reports evaluate myxomas by cine gradient refocused echo and by delayed hyper-enhancement pattern (3,4). Thrombus has also recently been reported with the use of MRI by both T1, T2 spin echo characteristics and by delayed enhancement sequences (5,6).…”

Cardiac metastasis from carcinoid tumour: Magnetic resonance imaging findings

“…Although myxomas can occur in any cardiac chamber, most myxomas arise in the interatrial septum at the margin of the fossa ovalis. Myxomas are often pedunculated heterogeneously enhancing masses and demonstrate low signal intensity on GRE due to the presence of iron within the tumour 16 . Other intracardiac masses that might present with low signal intensity on GRE sequences are cardiac melanoma, calcified lipoma, calcified metastatic deposits and thrombus.…”

Magnetic resonance imaging features of an infected right atrial myxoma

“…Thrombi could be excluded as significant enhancement was not shown. The presence of low signal intensity on cine GRE MRI has been attributed to the presence of iron within the tumour from previous haemorrhage 5,6 or the presence of calcium 7 . Stagnant blood as a result of atrial fibrillation may mimic a mass demonstrating intermediate signal intensity but increases in signal intensity on contrast MRI, whereas intermediate signal intensity thrombus will appear as a filling defect 8 .…”