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Evaluation of cardiac masses by CMR: a tertiary center experience of cases presenting with suspicion of mass by echo or CT

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To evaluate the effectiveness of Cardiac Magnetic Resonance Imaging (CMR) in evaluation of cardiac masses... Of 249 patients referred for CMR, 22 patients with evidence of mass on CMR were lost to follow up and could not be included in the analysis... Of the remaining 227 patients, 88 patients (39%) were found to have no evidence of mass... Fifty-two patients (23%) were found to have benign anatomic variants... Of the 87 patients (38%) with evidence of mass on CMR 18 were diagnosed accurately as malignancy (12 primary cardiac tumors, 6 metastatic tumors), and were confirmed by biopsy and/or PET scan, while the remaining 69 patients had features of either a benign mass or thrombus and were managed accordingly (Figure 1)... Of the 133 patients with no mass or anatomical variants, 65 had further follow up, which revealed 1 benign mass that was not seen on MRI... Sixty-eight patients did not have follow up at our institution... We demonstrate that CMR can play a key role in making an accurate diagnosis... In our consecutive case series, over 62% of patients referred for mass evaluation were found to have either no evidence of mass or benign anatomical variants, thus saving patients further invasive work up and potential radiation exposure. 75 patients with no evidence of mass or benign variants did not have further follow up at our institution. 65 patients who did have follow up, only one patient was noted to have a benign mass persistent on subsequent imaging, but missed on CMR due to artifact... CMR also provided 100% sensitivity in the evaluation of malignant masses, making it a very effective screening tool in an oncologic work up when indicated... Additionally, in the presence of a mass, CMR can provide accurate differentiation of benign and malignant lesions

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Images A-B: Patient with large right atrial appendage simulating mass on echo; Images C-D: Patient with carcinoid tumor involving the left atrium and A-V Groove Demonstrating heterogenous early enhancement on perfusion.
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Figure 2: Images A-B: Patient with large right atrial appendage simulating mass on echo; Images C-D: Patient with carcinoid tumor involving the left atrium and A-V Groove Demonstrating heterogenous early enhancement on perfusion.

Mentions: Of 249 patients referred for CMR, 22 patients with evidence of mass on CMR were lost to follow up and could not be included in the analysis. Of the remaining 227 patients, 88 patients (39%) were found to have no evidence of mass. Fifty-two patients (23%) were found to have benign anatomic variants. Of the 87 patients (38%) with evidence of mass on CMR 18 were diagnosed accurately as malignancy (12 primary cardiac tumors, 6 metastatic tumors), and were confirmed by biopsy and/or PET scan, while the remaining 69 patients had features of either a benign mass or thrombus and were managed accordingly (Figure 1). Of the 133 patients with no mass or anatomical variants, 65 had further follow up, which revealed 1 benign mass that was not seen on MRI. Sixty-eight patients did not have follow up at our institution. A case of an anatomic variant (giant right atrial appendage) and a case of malignant carcinoid are shown in Figure 2


Evaluation of cardiac masses by CMR: a tertiary center experience of cases presenting with suspicion of mass by echo or CT
Images A-B: Patient with large right atrial appendage simulating mass on echo; Images C-D: Patient with carcinoid tumor involving the left atrium and A-V Groove Demonstrating heterogenous early enhancement on perfusion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4044092&req=5

Figure 2: Images A-B: Patient with large right atrial appendage simulating mass on echo; Images C-D: Patient with carcinoid tumor involving the left atrium and A-V Groove Demonstrating heterogenous early enhancement on perfusion.
Mentions: Of 249 patients referred for CMR, 22 patients with evidence of mass on CMR were lost to follow up and could not be included in the analysis. Of the remaining 227 patients, 88 patients (39%) were found to have no evidence of mass. Fifty-two patients (23%) were found to have benign anatomic variants. Of the 87 patients (38%) with evidence of mass on CMR 18 were diagnosed accurately as malignancy (12 primary cardiac tumors, 6 metastatic tumors), and were confirmed by biopsy and/or PET scan, while the remaining 69 patients had features of either a benign mass or thrombus and were managed accordingly (Figure 1). Of the 133 patients with no mass or anatomical variants, 65 had further follow up, which revealed 1 benign mass that was not seen on MRI. Sixty-eight patients did not have follow up at our institution. A case of an anatomic variant (giant right atrial appendage) and a case of malignant carcinoid are shown in Figure 2

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

To evaluate the effectiveness of Cardiac Magnetic Resonance Imaging (CMR) in evaluation of cardiac masses... Of 249 patients referred for CMR, 22 patients with evidence of mass on CMR were lost to follow up and could not be included in the analysis... Of the remaining 227 patients, 88 patients (39%) were found to have no evidence of mass... Fifty-two patients (23%) were found to have benign anatomic variants... Of the 87 patients (38%) with evidence of mass on CMR 18 were diagnosed accurately as malignancy (12 primary cardiac tumors, 6 metastatic tumors), and were confirmed by biopsy and/or PET scan, while the remaining 69 patients had features of either a benign mass or thrombus and were managed accordingly (Figure 1)... Of the 133 patients with no mass or anatomical variants, 65 had further follow up, which revealed 1 benign mass that was not seen on MRI... Sixty-eight patients did not have follow up at our institution... We demonstrate that CMR can play a key role in making an accurate diagnosis... In our consecutive case series, over 62% of patients referred for mass evaluation were found to have either no evidence of mass or benign anatomical variants, thus saving patients further invasive work up and potential radiation exposure. 75 patients with no evidence of mass or benign variants did not have further follow up at our institution. 65 patients who did have follow up, only one patient was noted to have a benign mass persistent on subsequent imaging, but missed on CMR due to artifact... CMR also provided 100% sensitivity in the evaluation of malignant masses, making it a very effective screening tool in an oncologic work up when indicated... Additionally, in the presence of a mass, CMR can provide accurate differentiation of benign and malignant lesions

No MeSH data available.


Related in: MedlinePlus