Cardiac Masses

Vivian S. Lee1

1 New York University Medical Center, New York, New York
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A11.2
DOI:  10.1002/0471142719.mia1102s00
Online Posting Date:  May, 2001
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Abstract

Magnetic Resonance Imaging (MRI) may be indicated in patients who have poor acoustic windows or in whom lesions are incompletely characterized by echocardiography. This unit presents a basic technique for evaluating cardiac masses, with optional contrast-enhanced sequences for specific indications. The parameters are based on experience on a Siemens 1.5 T Vision or Symphony and should be altered accordingly for different field strengths and machines from different manufacturers.

     
 
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Table of Contents

  • Unit Introduction
  • Basic Protocol: Imaging of Cardiac Masses
  • Commentary
  • Bibliography
  • Figures
  • Tables
     
 
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Materials

Basic Protocol: Imaging of Cardiac Masses

 Materials
  • Normal saline (0.9% NaCl), sterile
  • Gadolinium-based MR contrast agent (e.g., Magnevist, Omniscan, or Prohance)
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Figures

  •  FigureFigure A11.2.1 Left atrial myxoma. (A) Transverse T1-weighted turbo spin echo and (B) transverse cine gradient echo show a large mass in the left atrium (M).
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  •  FigureFigure A11.2.2 Atrial lipoma. (A) Transverse HASTE image and (B) transverse short TI inversion-recovery image through the right atrium demonstrate a large mass in the right atrial wall (curved arrows) and also involving the interatrial septum (shorter arrowhead in A). The lesion is high in signal intensity on the HASTE image. The loss of signal intensity in the mass on the inversion-recovery sequence parallels that of subcutaneous fat and supports the diagnosis of right atrial lipoma with involvement of the internal septum.
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  •  FigureFigure A11.2.3 Right atrial pseudotumor. Transverse cine gradient-echo image shows a typical nodular appearance of the right atrial pseudotumor, seen along the posterior wall of the right atrium (arrowheads). This is a normal structure and should not be mistaken for tumor or thrombus.
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Videos

Literature Cited

 Literature Cited
    Barakos, J.A., Brown, J.J., and Higgins, C.B. 1989. MR imaging of secondary cardiac and paracardiac lesions. Am. J. Roentgenol. 153:47-50.
    Higgins, C.B. 1992. Essentials of Cardiac Radiology and Imaging. J.B. Lippincott, New York.
    Martin, E.T., Fuisz, A.R., and Pohost, G.M. 1998. Imaging cardiac structure and pump function. Cardiol. Clin. 16:135-160.
    Meier, R.A. and Hartnell, G.G. 1994. MRI of right atrial pseudomass: Is it really a diagnostic problem? J. Comput. Assist. Tomogr. 18:398-401.
    Mirowitz, S.A. and Gutierrez, F.R. 1992. Fibromuscular elements of the right atrium: Pseudomass at MR imaging. Radiology 182:231-233.
 Key References
    Dupuis, K., Thangaraj, V., and Edelman, R.R. 1996. Practical MRI for the technologist and imaging specialist. In Clinical Magnetic Resonance Imaging (R.R. Edelman, J.R. Hesselink, and M.B. Zlatkin, eds.) pp. 52-87. W.B. Saunders, Philadelphia.

Covers a wide range of practical information for setting patients up for MRI and also includes a useful description of cardiac imaging sequence parameters.

    See above.

Contains a detailed description of methods to evaluate cardiac masses, including plain film diagnoses and MRI.

    White, C.S. 1996. MR evaluation of the pericardium and cardiac malignancies. MRI Clin. North Am. 4:237-251.

Reviews MRI findings of cardiac masses.

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