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Multidetector CT and MR imaging of cardiac tumors.

Kim EY, Choe YH, Sung K, Park SW, Kim JH, Ko YH - Korean J Radiol (2009)

Bottom Line: The purpose of this article is to provide a current review of the spectrum of multidetector CT (MDCT) and MRI findings for a variety of cardiac neoplasms.In the diagnosis of cardiac tumors, the use of MDCT and MRI can help differentiate benign from malignant masses.Knowledge of the characteristic MRI findings of benign cardiac tumors or thrombi can be helpful to avoid unnecessary surgical procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.

ABSTRACT
The purpose of this article is to provide a current review of the spectrum of multidetector CT (MDCT) and MRI findings for a variety of cardiac neoplasms. In the diagnosis of cardiac tumors, the use of MDCT and MRI can help differentiate benign from malignant masses. Especially, the use of MDCT is advantageous in providing anatomical information and MRI is useful for tissue characterization of cardiac masses. Knowledge of the characteristic MRI findings of benign cardiac tumors or thrombi can be helpful to avoid unnecessary surgical procedures. Presurgical assessment of malignant cardiac tumors with the use of MDCT and MRI may allow determination of the resectability of tumors and planning for the reconstruction of cardiac chambers.

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Related in: MedlinePlus

Left atrial myxoma in 65-year-old male.A. Reformatted ECG-gated multidetector CT image shows left atrial mass attached to interatrial septum by broad pedicle (arrows). Note strong contrast enhancement in part of mass with foci of calcification (arrowhead).B. Gross specimen shows myxoid soft tissue mass with pale yellow and dark brown colors, which probably represent mixture of hemorrhage, necrosis, cyst formation and fibrosis.
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Figure 2: Left atrial myxoma in 65-year-old male.A. Reformatted ECG-gated multidetector CT image shows left atrial mass attached to interatrial septum by broad pedicle (arrows). Note strong contrast enhancement in part of mass with foci of calcification (arrowhead).B. Gross specimen shows myxoid soft tissue mass with pale yellow and dark brown colors, which probably represent mixture of hemorrhage, necrosis, cyst formation and fibrosis.

Mentions: Myxomas are the most common benign tumor found in adults; these tumors present in adulthood between the fourth and seventh decades (5). The classic triad of symptoms includes cardiac obstructive symptoms related to the obstruction of blood flow (Fig. 1), embolic events, and constitutional symptoms such as fever, malaise and weight loss. Thromboembolic events occur in 35% of left-sided myxomas to the brain, kidney, spleen and extremities and 10% of right-sided myxomas to the lung (5-7). Friable and gelatinous myxomas are more likely to embolize than firm and fibrous lesions (6). Approximately 75% of myxomas are found in the left atrium, typically, in the interatrial septum in the region of the fossa ovalis; 20% of myxomas are located in the right atrium, and rare cases are found in the ventricles. The use of contrast-enhanced CT usually demonstrates the presence of a well-defined spherical or ovoid intracavitary mass, which typically has lobular contours (Fig. 2). Tumor attenuation is lower than that of the unopacified blood. The intravenous administration of a contrast material helps better to define the lesion as a mass of low attenuation that is surrounded by enhancing intracardiac blood. Heterogeneity is a common feature of myxomas and is believed to reflect hemorrhage, necrosis, cyst formation, fibrosis or calcification. Myxomas tend to show markedly increased signal intensity as seen on the T2-weighted MR images (Fig. 3). However, myxomas can show areas of decreased signal intensity due to the presence of calcification or magnetic susceptibility artifacts caused by hemosiderin (8).


Multidetector CT and MR imaging of cardiac tumors.

Kim EY, Choe YH, Sung K, Park SW, Kim JH, Ko YH - Korean J Radiol (2009)

Left atrial myxoma in 65-year-old male.A. Reformatted ECG-gated multidetector CT image shows left atrial mass attached to interatrial septum by broad pedicle (arrows). Note strong contrast enhancement in part of mass with foci of calcification (arrowhead).B. Gross specimen shows myxoid soft tissue mass with pale yellow and dark brown colors, which probably represent mixture of hemorrhage, necrosis, cyst formation and fibrosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651440&req=5

Figure 2: Left atrial myxoma in 65-year-old male.A. Reformatted ECG-gated multidetector CT image shows left atrial mass attached to interatrial septum by broad pedicle (arrows). Note strong contrast enhancement in part of mass with foci of calcification (arrowhead).B. Gross specimen shows myxoid soft tissue mass with pale yellow and dark brown colors, which probably represent mixture of hemorrhage, necrosis, cyst formation and fibrosis.
Mentions: Myxomas are the most common benign tumor found in adults; these tumors present in adulthood between the fourth and seventh decades (5). The classic triad of symptoms includes cardiac obstructive symptoms related to the obstruction of blood flow (Fig. 1), embolic events, and constitutional symptoms such as fever, malaise and weight loss. Thromboembolic events occur in 35% of left-sided myxomas to the brain, kidney, spleen and extremities and 10% of right-sided myxomas to the lung (5-7). Friable and gelatinous myxomas are more likely to embolize than firm and fibrous lesions (6). Approximately 75% of myxomas are found in the left atrium, typically, in the interatrial septum in the region of the fossa ovalis; 20% of myxomas are located in the right atrium, and rare cases are found in the ventricles. The use of contrast-enhanced CT usually demonstrates the presence of a well-defined spherical or ovoid intracavitary mass, which typically has lobular contours (Fig. 2). Tumor attenuation is lower than that of the unopacified blood. The intravenous administration of a contrast material helps better to define the lesion as a mass of low attenuation that is surrounded by enhancing intracardiac blood. Heterogeneity is a common feature of myxomas and is believed to reflect hemorrhage, necrosis, cyst formation, fibrosis or calcification. Myxomas tend to show markedly increased signal intensity as seen on the T2-weighted MR images (Fig. 3). However, myxomas can show areas of decreased signal intensity due to the presence of calcification or magnetic susceptibility artifacts caused by hemosiderin (8).

Bottom Line: The purpose of this article is to provide a current review of the spectrum of multidetector CT (MDCT) and MRI findings for a variety of cardiac neoplasms.In the diagnosis of cardiac tumors, the use of MDCT and MRI can help differentiate benign from malignant masses.Knowledge of the characteristic MRI findings of benign cardiac tumors or thrombi can be helpful to avoid unnecessary surgical procedures.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.

ABSTRACT
The purpose of this article is to provide a current review of the spectrum of multidetector CT (MDCT) and MRI findings for a variety of cardiac neoplasms. In the diagnosis of cardiac tumors, the use of MDCT and MRI can help differentiate benign from malignant masses. Especially, the use of MDCT is advantageous in providing anatomical information and MRI is useful for tissue characterization of cardiac masses. Knowledge of the characteristic MRI findings of benign cardiac tumors or thrombi can be helpful to avoid unnecessary surgical procedures. Presurgical assessment of malignant cardiac tumors with the use of MDCT and MRI may allow determination of the resectability of tumors and planning for the reconstruction of cardiac chambers.

Show MeSH
Related in: MedlinePlus