Role of magnetic resonance imaging for evaluation of tumors in the cardiac region

Abstract

The aim of this study was to review the role of MRI in the assessment of heart neoplasm, 25 cases with heart neoplasm (10 myxoma, 6 rhabdomyoma, 5 angiosarcoma, 2 mesothelioma, 1 lymphoma, and 1 fibroma) were examined with MRI and echocardiography. Multislice T1- and T2-weighted spin-echo images and static gradient-echo images were taken in appropriate directions with electrocardiogram gating. Gadolinium enhancement was performed in 21 cases. Transthoracic echocardiography was performed in all cases. Except for the 5 patients with rhabdomyoma, the pathological diagnosis was obtained. MRI proved to be useful for tissue characterization of myxoma, angiosarcoma, mesothelioma, and fibroma in cases with tuberous sclerosis. MRI also proved to be useful for detection of the tumor, depiction of contour, relation with other cardiac structures, in cases with myxoma, angiosarcoma, mesothelioma, lymphoma, and fibroma. In the differential diagnosis, MRI provided important information in cases with myxoma, rhabdomyoma, angiosarcoma, and fibroma. In cases with tumors expanding into the mediastinum, such as mesothelioma and fibroma in this report, MRI was useful in determining the location and border. In cases with tumors adjacent to pericardium, MRI was useful in detecting pericardial invasion. Gadolinium enhancement added useful information in cases with myxoma, rhabdomyoma, angiosarcoma, and mesothelioma. The role of MRI with and without Gd enhancement differs somewhat in individual types of heart neoplasm, and adaptation must be considered in each kind of neoplasm. On the other hand, MRI is an essential examination in all cases with a cardiac mass, which has not been diagnosed, since it may provide useful information for the differential diagnosis.

Evaluation of cardiac tumors with magnetic resonance imaging

“…The masses are usually isointense to the myocardium on T1-weighted images, hyperintense on T2-weighted images and show heterogeneous contrast enhancement ( Fig. 1) [1,14,15]. Less commonly myxomas can be heterogeneous on both T1-and T2-weighted images due to the presence of calcification, hemorrhage or necrosis [11,15].…”

Dynamic contrast-enhanced MRI for evaluation of cardiac tumors

“…Sir, It is with great interest we read the articles about magnetic resonance imaging (MRI) of cardiac tumors in European Radiology [1][2][3][4][5]. Some authors stress the value of contrast media in the diagnostic workup of cardiac tumors, e.g., for differentiation of tumor and additional thrombi [6].…”

Pericardial Masses, Cysts and Diverticula: A Comprehensive Review Using Multimodality Imaging

“…10 Series evaluating cardiac tumors, either primary or metastatic, have been conducted in small diverse samples showing variable patterns with gadolinium contrast administration ranging from heterogenous to diffuse uptake. 22,40,[56][57][58] Heterogenous gadolinium uptake has been correlated with increased lesion nodularity and has been hypothesized to represent areas of tumor necrosis and rapid growth.…”