Diagnostic Performance of Cardiac Magnetic Resonance Imaging and Echocardiography in Evaluation of Cardiac and Paracardiac Masses

Patel, R. D.; Lim, Ruth; Sarić, Muhamed; Nayar, Ambika C.; Babb, James S.; Ettel, Mark; Axel, Leon; Srichai, Monvadi B.

doi:10.1016/j.amjcard.2015.10.014

Cited by 49 publications

(19 citation statements)

References 9 publications

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“…However, location can aid diagnosis with these neoplasms typically arising from the left atrium apart from myxoma, which most commonly arises from the interatrial septum 7. Imaging findings associated with malignant lesions include location in the right heart, local invasion (characterised by a loss of tissue planes), lack of T2 hyperintensity, non-mobility and a coexistent pericardial effusion 8. In our patient, the discrepancy in extent of enhancement on the CTCA and MRI is related to the different phase of contrast enhancement.…”

Section: Discussionmentioning

confidence: 99%

Enlarging left atrial haemangioma in a patient with Cowden syndrome

Lamanna¹,

Lim

Yap

et al. 2019

BMJ Case Rep

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A 53-year-old female patient known to have Cowden disease (PTEN mutation positive) was found to have a mass at the left atrium on a CT coronary angiography performed as part of a preoperative workup for an unrelated surgery. Further radiological characterisation of the lesion was achieved using MRI and positron emission tomography. Interval growth prompted surgical excision; however, surgery was expedited after the patient presented with haemopericardium and cardiac tamponade. The patient was discharged home 8 days postoperatively, and no intraoperative or postoperative complications were encountered. A diagnosis of cavernous haemangioma was made on histology.

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Section: Discussionmentioning

confidence: 99%

Enlarging left atrial haemangioma in a patient with Cowden syndrome

Lamanna¹,

Lim

Yap

et al. 2019

BMJ Case Rep

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“…CMR provides valuable additional anatomic information and tissue characterization if the etiology or effects of a cardiac mass are not clear. CMR has excellent accuracy for the differentiation of cardiac thrombi from tumors and provides important information in the evaluation of benign vs malignant neoplasms . However, imaging features of hamartomas of mature cardiac myocytes can be variable, and tissue microscopy is the gold standard to establish definitive diagnosis of a cardiac mass.…”

Section: Discussionmentioning

confidence: 99%

Advanced cardiac imaging techniques assist in characterizing a cardiac mass and directing management

et al. 2017

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Advanced imaging techniques, including contrast echocardiography and CMR, provided valuable characterization and evaluation of a boy with an unusual cardiac mass. Imaging features assisted with differentiation of benign from malignant etiology and excluding thrombus. Accurate imaging techniques saved our patient risks associated with unnecessary surgery or anticoagulation. The ability to accurately define size serially assisted in guiding expectant management. He died from a noncardiac cause at age 28, and autopsy demonstrated a hamartoma of mature cardiac myocytes.

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“…Cine MR sequences (FIESTA) in the short axis, in the long axis, and in the four-chamber view were also obtained. After the injection of gadolinium-based contrast agent, we obtained post-contrast T1 black-blood fast spin echo images through the center of the cardiac mass (12,19…”

Section: Cardiac Mrimentioning

confidence: 99%

“…In contrast, systemic chemotherapy applies in patients with cardiac metastases. Some patients have surgical resection, or palliative care (12)(13)(14)(15). Although it is important to distinguish between primary cardiac and metastatic cardiac masses, currently there are limited diagnostic approaches (16,17).…”

mentioning

confidence: 99%

Differentiation of Primary Cardiac Tumors from Metastatic Tumors by Non-invasive Cardiac Imaging

Otomi

Otsuka

Arase

et al. 2018

Annals of Nuclear Cardiology

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Background: Various imaging modalities are used to identify and characterize cardiac masses. While echocardiography remains the preferred imaging modality to evaluate cardiac masses, computed tomography (CT), magnetic resonance imaging (MRI), and 18 F-fluorodeoxyglucose positron emission tomography (18 F-FDG PET)/CT are being increasingly employed to assess cardiac mass lesions. However, the clinical value of noninvasive cardiac imaging for differentiating between primary cardiac mass and metastatic lesions has not yet been examined in detail. The purpose of the present study was to evaluate the diagnostic utility of non-invasive cardiac imaging for differentiating primary cardiac tumors from metastatic lesions, and non-tumorous lesions. Methods: A retrospective review was conducted on 22 cardiac mass lesions in 20 patients assessed by cardiac imaging (at least one of CT, MRI, or 18 F-FDG PET/CT) between December 2005 and March 2017. CT findings included the tumor size, location, existence of calcification, and morphology of the base portion of the lesion. MRI parameters included signals with T1-weighted imaging (T1WI), T2WI, mobility with cine imaging, and contrast enhancement. Tracer uptake by each cardiac lesion using 18 F-FDG PET/CT was also evaluated. Results: Among 17 cardiac mass lesions assessed by contrast-enhanced CT, all cardiac myxomas and papillary fibroelastomas had a pedunculated base portion. All metastases located in the cavity had a sessile base portion (P=0.0035). Malignant tumors (metastases and malignant lymphoma) had no mobility, while cardiac myxomas had a slightly higher frequency of mobility with cine MRI (0% vs. 100%, P=0.0667). Among the four lesions for which 18 F-FDG PET/CT was performed, the three malignant lesions had strong 18 F-FDG uptake, while the benign lesion showed insignificant accumulation. Conclusions: The characteristics of the base portion of cardiac mass were useful for differentiating primary cardiac tumors from metastatic cardiac tumors. Cine MRI also exhibited diagnostic utility for differentiating between primary cardiac tumors and metastases. Therefore, non-invasive cardiac imaging may be employed to differentiate cardiac mass lesions. The accurate diagnosis of cardiac mass lesions may require the assessment of multiple characteristics on images.

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Diagnostic Performance of Cardiac Magnetic Resonance Imaging and Echocardiography in Evaluation of Cardiac and Paracardiac Masses

Cited by 49 publications

References 9 publications

Enlarging left atrial haemangioma in a patient with Cowden syndrome

Enlarging left atrial haemangioma in a patient with Cowden syndrome

Advanced cardiac imaging techniques assist in characterizing a cardiac mass and directing management

Differentiation of Primary Cardiac Tumors from Metastatic Tumors by Non-invasive Cardiac Imaging

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