MR Imaging of Cardiac Tumors and Masses: A Review of Methods and Clinical Applications

Abstract

Cardiac masses are usually first detected at echocardiography. In their further evaluation, cardiac magnetic resonance (MR) imaging has become a highly valuable technique. MR imaging offers incremental value owing to its larger field of view, superior tissue contrast, versatility in image planes, and unique ability to enable discrimination of different tissue characteristics, such as water and fat content, which give rise to particular signal patterns with T1- and T2-weighted techniques. With contrast material-enhanced MR imaging, additional tissue properties such as vascularity and fibrosis can be demonstrated. MR imaging can therefore contribute to the diagnosis of a cardiac mass as well as be used to detail its relationship to other cardiac and extracardiac structures. These assessments are important to plan therapy, such as surgical intervention. In addition, serial MR studies can be used to monitor tumor regression after surgery or chemotherapy. Primary cardiac tumors are very rare; metastases and pseudotumors (eg, thrombus) are much more common. This article provides an overview of cardiac masses and reviews the optimal MR imaging techniques for their assessment.

Refractory Heart Failure despite Optimized Medical Treatment Which Subsides only after Surgical Resection of a Large Left Atrial Myxoma

“…AM usually appear at the age of 30 to 60 years old [1][2][3][4]. Atrial myxomas tend to differ in shape, size, and texture, and originate from the vicinity of the fossa ovalis in the inter-atrial septum in 75% of cases like in the patient that we are presenting here.…”

“…Survival after total resection of the AM is high. Nevertheless, since there is a 1% to 3% recurrence long-term follow-up with echocardiography is highly recommended [1][2][3]. With the advent of current auxiliary diagnostic methods, it is now feasible to do genetic studies and screen the relatives of patients having atrial myxomas to rule out additional occult familial cases and perform a surgical resection as early as possible to avoid cardiac and systemic complications in asymptomatic patients.…”

“…Half of these rare cardiac tumors are AM [1]. The global annual incidence of AM is 0.5 per million people and 75% of them are located in the left atrium [2]. The clinical presentation varies among patients and certainly revealing mixed stromal tissue ( Figure 3).…”

“…It can be asymptomatic, although the typical symptoms involve systemic embolism, heart failure, or non-specific symptoms. Systemic embolism occurs in 25% to 50% of left AM and about half of them travel to the central nervous system [2,3]. The clinical diagnosis of AM is based on imaging methodology like echocardiography, cardiac computerized tomography or cardiac magnetic resonance imaging.…”

Disease-specific cardiovascular positron emission tomography/magnetic resonance imaging: a brief review of the current literature

“…Generally, transthoracic echocardiography and CT are the first line imaging modalities in detecting abnormal cardiac masses, owing to their widespread use. MR imaging is generally considered the gold standard (55,56): in a skilled center, a combination of cine, T1-weighted, T2-weighted, fat-suppression, first pass perfusion and LGE can assess the location, size, vascularity, and tissue characteristics of the cardiac mass. In one study, cardiac MR was noted to have a diagnostic accuracy of 92% (56).…”