Differentiation of Cardiac Masses by Cardiac Magnetic Resonance Imaging

A rare case of left atrial myxofibromyosarcoma

“…Infection, surgical, or radiation changes may at times lead to false positive 18 F-FDG uptake [16] . Hybrid modalities such as PET/MRI, PET/CT add incremental value and enhance the diagnostic accuracy [17] .…”

Urgent Need for Diagnosis of a Rapidly Growing Right Atrial Mass

“…Since a malignant condition is in the differential diagnosis in a patient with a cardiac mass, constitutional symptoms, pulmonary nodules, and mediastinal lymphadenopathy, T1-weighted and T2-weighted images were better able to distinguish different tumor characteristics than a positron emission tomography-computed tomography (PET-CT) scan (choice B). 1,2 Furthermore, a transesophageal echocardiogram (choice D) would not provide further tissue characterization of the right atrial mass. For example, more vascularized masses are enhanced on T1weighted imaging, and areas of hemorrhage, edema, and necrosis are enhanced on T2-weighted imaging.…”

“…A cMRI provides optimal multiplanar images for tissue and blood flow characterization without radiation. Since a malignant condition is in the differential diagnosis in a patient with a cardiac mass, constitutional symptoms, pulmonary nodules, and mediastinal lymphadenopathy, T1-weighted and T2-weighted images were better able to distinguish different tumor characteristics than a positron emission tomography–computed tomography (PET-CT) scan (choice B) . Furthermore, a transesophageal echocardiogram (choice D) would not provide further tissue characterization of the right atrial mass.…”

“…For example, more vascularized masses are enhanced on T1-weighted imaging, and areas of hemorrhage, edema, and necrosis are enhanced on T2-weighted imaging. Additionally, the use of first-pass perfusion imaging with early and late gadolinium enhancement can identify infiltration, thrombus, and hemorrhage . This combination of findings can create a virtual fingerprint to differentiate between cardiac masses, such as fibromas, myxomas, and sarcomas, and assist in biopsy guidance.…”

“…first-pass perfusion imaging with early and late gadolinium enhancement can identify infiltration, thrombus, and hemorrhage. [1][2][3][4] This combination of findings can create a virtual fingerprint to differentiate between cardiac masses, such as fibromas, myxomas, and sarcomas, and assist in biopsy guidance. For these reasons, a cMRI was pursued prior to a PET-CT scan.…”