Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of cardiac masses by CMR—strengths and pitfalls: a tertiary center experience

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Cardiovascular magnetic resonance (CMR) imaging is often considered the reference method to assess cardiac tumors. However, little data exists concerning the effectiveness of CMR for the accurate diagnosis of cardiac masses. We sought to understand the diagnostic value of CMR for evaluation of suspected cardiac mass. A total of 249 consecutive CMR cases performed at a single center from January 2005 to June 2013 for evaluation of masses found on echocardiography or computed tomography (CT) were included. All the clinical data and imaging features of these patients were retrospectively reviewed and medical records were verified for follow up care. More than half of the patients referred for evaluation of masses found at echocardiography or CT were found to have no evidence of mass by CMR. CMR correctly differentiated between thrombus and myxoma in 88.4 % cases. Malignant masses were accurately diagnosed on CMR. However, CMR missed or misdiagnosed a few cases of benign masses. Diagnosing cardiac masses remains an important use for imaging, despite technical difficulties with current imaging modalities. CMR can play a key role in confirming presence or absence of a mass. Additionally, in the presence of a mass, CMR can provide accurate differentiation of pseudomasses, benign and malignant masses. However, the limitations of CMR must be recognized.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Butany J, Nair V, Naseemuddin A, Nair GM, Catton C, Yau T (2005) Cardiac tumours: diagnosis and management. Lancet Oncol 6(4):219–228. doi:10.1016/S1470-2045(05)70093-0

    Article  PubMed  Google Scholar 

  2. Braggion-Santos MF, Koenigkam-Santos M, Teixeira SR, Volpe GJ, Trad HS, Schmidt A (2013) Magnetic resonance imaging evaluation of cardiac masses. Arq Bras Cardiol 101(3):263–272. doi:10.5935/abc.20130150

    PubMed  PubMed Central  Google Scholar 

  3. Fussen S, De Boeck BW, Zellweger MJ, Bremerich J, Goetschalckx K, Zuber M, Buser PT (2011) Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours. Eur Heart J 32(12):1551–1560. doi:10.1093/eurheartj/ehr104

    Article  PubMed  Google Scholar 

  4. Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, Plein S (2013) MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology 268(1):26–43. doi:10.1148/radiol.13121239

    Article  PubMed  Google Scholar 

  5. Gulati G, Sharma S, Kothari SS, Juneja R, Saxena A, Talwar KK (2004) Comparison of echo and MRI in the imaging evaluation of intracardiac masses. Cardiovasc Intervent Radiol 27(5):459–469. doi:10.1007/s00270-004-0123-4

    Article  CAS  PubMed  Google Scholar 

  6. Lam KY, Dickens P, Chan AC (1993) Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies. Arch Pathol Lab Med 117(10):1027–1031

    CAS  PubMed  Google Scholar 

  7. Butany J, Leong SW, Carmichael K, Komeda M (2005) A 30-year analysis of cardiac neoplasms at autopsy. Can J Cardiol 21(8):675–680

    PubMed  Google Scholar 

  8. Buckley O, Madan R, Kwong R, Rybicki FJ, Hunsaker A (2011) Cardiac masses, part 1: imaging strategies and technical considerations. AJR Am J Roentgenol 197(5):W837–W841. doi:10.2214/AJR.10.7260

    Article  PubMed  PubMed Central  Google Scholar 

  9. Carson W, Chiu SS (1998) Image in cardiovascular medicine. Eustachian valve mimicking intracardiac mass. Circulation 97(21):2188

    Article  CAS  PubMed  Google Scholar 

  10. Gupta S, Plein S, Greenwood JP (2009) The Coumadin Ridge: an important example of a left atrial pseudotumour demonstrated by cardiovascular magnetic resonance imaging. J Radiol Case Reports 3(9):1–5. doi:10.3941/jrcr.v3i9.210

    Article  Google Scholar 

  11. Mitta SR (2012) Moderator band wrongly interpreted as RV mass. J Assoc Phys India 60:42

    CAS  Google Scholar 

  12. Zarauza MJ, Alonso F, Hidalgo M, Hernando JP, Oliva MJ, Zueco J, Martin Duran R, Ochoteco A (1993) Lipomatous hypertrophy of the interatrial septum simulating an atrial mass in a patient with a pulmonary embolism: its diagnosis by transesophageal echocardiography and percutaneous biopsy. Rev Esp Cardiol 46(11):761–764

    CAS  PubMed  Google Scholar 

  13. Castillo JA, Vilacosta I, Iniguez A, San Roman JA, Zamorano JL, Almeria C, Sanchez-Harguindey L (1993) A large aneurysm of the interatrial septum simulating an atrial mass. Its identification by transesophageal echocardiography. Rev Esp Cardiol 46(10):677–679

    CAS  PubMed  Google Scholar 

  14. Ward TJ, Kadoch MA, Jacobi AH, Lopez PP, Salvo JS, Cham MD (2013) Magnetic resonance imaging of benign cardiac masses: a pictorial essay. J Clin Imaging Sci 3:34. doi:10.4103/2156-7514.117458

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jungehulsing M, Sechtem U, Theissen P, Hilger HH, Schicha H (1992) Left ventricular thrombi: evaluation with spin-echo and gradient-echo MR imaging. Radiology 182(1):225–229. doi:10.1148/radiology.182.1.1727287

    Article  CAS  PubMed  Google Scholar 

  16. Mollet NR, Dymarkowski S, Volders W, Wathiong J, Herbots L, Rademakers FE, Bogaert J (2002) Visualization of ventricular thrombi with contrast-enhanced magnetic resonance imaging in patients with ischemic heart disease. Circulation 106(23):2873–2876

    Article  PubMed  Google Scholar 

  17. Paydarfar D, Krieger D, Dib N, Blair RH, Pastore JO, Stetz JJ Jr, Symes JF (2001) In vivo magnetic resonance imaging and surgical histopathology of intracardiac masses: distinct features of subacute thrombi. Cardiology 95(1):40–47

    Article  CAS  PubMed  Google Scholar 

  18. Hoey ET, Mankad K, Puppala S, Gopalan D, Sivananthan MU (2009) MRI and CT appearances of cardiac tumours in adults. Clin Radiol 64(12):1214–1230. doi:10.1016/j.crad.2009.09.002

    Article  CAS  PubMed  Google Scholar 

  19. Grebenc ML, Rosado de Christenson ML, Burke AP, Green CE, Galvin JR (2000) Primary cardiac and pericardial neoplasms: radiologic-pathologic correlation. Radiographics 20 (4):1073–1103; quiz 1110–1071, 1112. doi:10.1148/radiographics.20.4.g00jl081073

  20. Wintersperger BJ, Becker CR, Gulbins H, Knez A, Bruening R, Heuck A, Reiser MF (2000) Tumors of the cardiac valves: imaging findings in magnetic resonance imaging, electron beam computed tomography, and echocardiography. Eur Radiol 10(3):443–449. doi:10.1007/s003300050073

    Article  CAS  PubMed  Google Scholar 

  21. Vallurupalli S, Hayes K, Bhatti S (2014) Ventricular papillary fibroelastoma. J Am Coll Cardiol 63(20):2170. doi:10.1016/j.jacc.2013.12.060

    Article  PubMed  Google Scholar 

  22. Rogowitz E, Babiker HM, Krishnadasan R, Jokerst C, Miller TP, Bookman M (2013) Heart of lymphoma: primary mediastinal large B-cell lymphoma with endomyocardial involvement. Case Reports Oncol Med 2013:814291. doi:10.1155/2013/814291

    Google Scholar 

  23. Roberts WC (2001) Neoplasms involving the heart their simulators and adverse consequences of their therapy. Proceedings 14(4):358–376

    CAS  Google Scholar 

  24. Goldberg AD, Blankstein R, Padera RF (2013) Tumors metastatic to the heart. Circulation 128(16):1790–1794. doi:10.1161/CIRCULATIONAHA.112.000790

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

    Authors and Affiliations

    1. Cardiovascular Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

      Roja Tumma & Harold Litt

    2. Department of Radiology, Global Hospitals and Research Centre, Mt Abu, Rajasthan, India

      Roja Tumma

    3. Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

      Wei Dong, Jing Wang, Harold Litt & Yuchi Han

    4. Department of Cardiology, PLA General Hospital, Beijing, China

      Wei Dong & Jing Wang

    Authors
    1. Roja Tumma
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Wei Dong
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Jing Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Harold Litt
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Yuchi Han
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Yuchi Han.

    Ethics declarations

    Conflict of interest

    Author Roja Tumma declares that she has no conflict of interest. Author Wei Dong declares that she has no conflict of interest. Author Jing Wang declares that she has no conflict of interest. Author Harold Litt declares that he has no conflict of interest. Author Yuchi Han declares that she has no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was waived from individual participants included in the study for retrospective review of existing clinical data by the institutional review board.

    Additional information

    Roja Tumma and Wei Dong have contributed equally.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Tumma, R., Dong, W., Wang, J. et al. Evaluation of cardiac masses by CMR—strengths and pitfalls: a tertiary center experience. Int J Cardiovasc Imaging 32, 913–920 (2016). https://doi.org/10.1007/s10554-016-0845-9

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10554-016-0845-9

    Keywords

    Search

    Navigation