European Radiology

, Volume 15, Issue 7, pp 1446–1455 | Cite as

Evaluation of cardiac tumors with magnetic resonance imaging

  • Antonio LunaEmail author
  • Ramón Ribes
  • Pilar Caro
  • José Vida
  • Jeremy J. Erasmus


Primary cardiac neoplasms are rare, and are more commonly benign than malignant. However, metastases are by far the most common cardiac neoplasms. MRI allows evaluation of myocardial infiltration, pericardial involvement and/or extracardiac extension. MRI overcomes the usual limitations of echocardiography and assesses more accurately changes in cardiac function. Specific tumoral characterization is only possible in cases of myxoma, lipoma, fibroma and hemangioma. Suggestive features of malignancy are right side location, extracardiac extension, inhomogeneity in signal intensity of the tumor and pericardial effusion. The use of intravenous contrast material improves tumor characterization and depiction of tumor borders. MRI also allows differentiation of tumor from other nontumoral masses such as intracavitary tumors or fibromuscular elements of the posterior wall of the right atrium.


Heart MR, heart Neoplasms, heart Abnormalities, tissue characterization 


  1. 1.
    Krombach GA, Saeed M, Higgins CB (2003) Cardiac masses. In: Higgins CB, de Roos A (eds) Cardiovascular MRI and MRA. Lippincott Williams & Wilkins, Philadelphia, PA, pp 136–154Google Scholar
  2. 2.
    Lobo A, Lewis JF, Conti CR (2000) Intracardiac masses detected by echocardiography: case presentations and review of the literature. Clin Cardiol 23(9):702–708Google Scholar
  3. 3.
    Brown JJ, Barakos JA, Higgins CB (1989) Magnetic resonance imaging of cardiac and paracardiac masses. J Thorac Imaging 4:58–64Google Scholar
  4. 4.
    Schmidt HC, Tscholakoff D, Hricak H, Higgins CB (1985) MR image contrast and relaxation times of solid tumors in the chest, abdomen and pelvis. J Comput Assist Tomogr 9:738–748Google Scholar
  5. 5.
    Frank H (2002) Cardiac and paracardiac masses. In: Manning WJ, Pennell DJ (eds) Cardiovascular magnetic resonance. Churchill Livingstone, Philadelphia, PA, pp 342–354Google Scholar
  6. 6.
    Araoz PA, Eklund HE, Welch TJ, Breen JF (1999) CT and MR imaging of primary cardiac malignancies. Radiographics 19(6):1421–1434PubMedGoogle Scholar
  7. 7.
    Grebenc ML, Rosado-de-Christenson ML, Burke AP, Green CE, Galvin JR (2000) Primary cardiac and pericardial neoplasms: radiologic–pathologic correlation. Radiographics 20(4):1073–1103Google Scholar
  8. 8.
    Hoffmann U, Globits S, Schima W, et al (2003) Usefulness of magnetic resonance imaging of cardiac and paracardiac masses. Am J Cardiol 92(7):890–895CrossRefGoogle Scholar
  9. 9.
    Funari M, Fujita N, Peck WW, Higgins CB (1991) Cardiac tumors: assessment with Gd-DTPA enhanced MR imaging. J Comput Assist Tomogr 15(6):953–958Google Scholar
  10. 10.
    Burke A, Virmani R (1996) Tumors of the heart and great vessels, 3rd series, fasc 16. Armed Forces Institute of Pathology, Washington, DC, pp 1–98Google Scholar
  11. 11.
    Araoz PA, Mulvagh SL, Tazelaar HD, Julsrud PR, Breen JF (2000) CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics 20(5):1103–1319PubMedGoogle Scholar
  12. 12.
    Grebenc ML, Rosado-de-Christenson ML, Green CE, Burke AP, Galvin JR (2002) Cardiac myxoma: imaging features in 83 patients. Radiographics 22(3):673–689Google Scholar
  13. 13.
    Eckhardt BP, Dommann-Scherrer CC, Stuckmann G, Zollikofer CL, Wentz KU (2003) Giant cardiac myxoma with malignant transformed glandular structures. Eur Radiol 13(9):2099–2102CrossRefGoogle Scholar
  14. 14.
    Luna A, Ribes R, Caro P (2003) Tumores y otras masas cardiacas. In: Tardaguila FM, Ferreiros J (eds) Imagen cardiovascular avanzada: RM y TC. Panamericana, Madrid, pp 79–85Google Scholar
  15. 15.
    Kaminaga T, Takeshita T, Kimura I (2003) Role of magnetic resonance imaging for evaluation of tumors in cardiac regions. Eur Radiol 13(4):1–10CrossRefGoogle Scholar
  16. 16.
    Sun JP, Asher CR, Yang XS (2001) Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients. Circulation 103(22):2687–2693PubMedGoogle Scholar
  17. 17.
    Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB (1997) Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol 30(3):784–790CrossRefGoogle Scholar
  18. 18.
    al-Mohammad A, Pambakian H, Young C (1998) Fibroelastoma: case report and review of the literature. Heart 79(3):301–304Google Scholar
  19. 19.
    Go RT, O’Donnell JK, Underwood DA, et al (1985) Comparison of gated cardiac MRI and 2D echocardiography of intracardiac neoplasms. AJR Am J Roentgenol 145(1):21–25Google Scholar
  20. 20.
    Winkler M, Higgins CB (1987) Suspected intracardiac masses: evaluation with MR imaging. Radiology 165(1):117–122PubMedGoogle Scholar
  21. 21.
    Bouton S, Yang A, McCrindle BW, Kidd L, McVeigh ER, Zerhouni EA (1991) Differentiation of tumor from viable myocardium using cardiac tagging with MR imaging. J Comput Assist Tomogr 15(4):676–678Google Scholar
  22. 22.
    Semelka RC, Shoenut JP, Wilson ME, Pellech AE, Patton JN (1992) Cardiac masses: signal intensity features on spin-echo, gradient-echo, gadolinium-enhanced spin-echo, and TurboFLASH images. J Magn Reson Imaging 2(4):415–420Google Scholar
  23. 23.
    Brodwater B, Erasmus J, McAdams HP, Dodd L (1996) Case report. Pericardial hemangioma. J Comput Assist Tomogr 20(6):954–956CrossRefGoogle Scholar
  24. 24.
    Oshima H, Hara M, Kono T, Shibamoto Y, Mishima A, Akita S (2003) Cardiac hemangioma of the left atrial appendage: CT and MR findings. J Thorac Imaging 18(3):204–206CrossRefGoogle Scholar
  25. 25.
    Hamilton BH, Francis IR, Gross BH, et al (1997) Intrapericardial paragangliomas (pheochromocytomas): imaging features. AJR Am J Roentgenol 168(1):109–113Google Scholar
  26. 26.
    Heufelder AE, Hofbauer LC (1996) Greetings from below the aortic arch! The paradigm of cardiac paraganglioma. J Clin Endocrinol Metab 81(3):891–895CrossRefGoogle Scholar
  27. 27.
    Kocaoglu M, Bulakbasi N, Ugurel MS, Ors F, Tayfun C, Ucoz T (2003) Value of magnetic resonance imaging in the depiction of intravenous leiomyomatosis extending to the heart. J Comput Assist Tomogr 27(4):630–633CrossRefPubMedGoogle Scholar
  28. 28.
    Ben-Hamda K, Maatouk F, Ben-Farhat M, et al (2003) Eighteen-year experience with echinococcosus of the heart: clinical and echocardiographic features in 14 patients. Int J Cardiol 91(2–3):145–151CrossRefGoogle Scholar
  29. 29.
    Chiles C, Woodard PK, Gutierrez FR, Link KM (2001) Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics 21(2):439–449Google Scholar
  30. 30.
    Gilkeson RC, Chiles C (2003) MR evaluation of cardiac and pericardial malignancy. Magn Reson Imaging Clin N Am (1):173–186Google Scholar
  31. 31.
    Lazoglu AH, Da Silva MM, Iwahara M, et al (1994) Primary pericardial sarcoma. Am Heart J 127(2):453–458CrossRefGoogle Scholar
  32. 32.
    Baumgartner RA, Das SK, Shea M, LeMire MS, Gross BH (1988) The role of echocardiography and CT in the diagnosis of cardiac tumors. Int J Cardiovasc Imaging 3(1):57–60Google Scholar
  33. 33.
    Mollet NR, Dymarkowski S, Bogaert J (2003) MRI and CT revealing carcinoid heart disease. Eur Radiol 13 [Suppl 4]:L14–L18Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Antonio Luna
    • 1
    Email author
  • Ramón Ribes
    • 2
  • Pilar Caro
    • 3
  • José Vida
    • 4
  • Jeremy J. Erasmus
    • 5
  1. 1.MR UnitClinica Las NievesJaénSpain
  2. 2.MR Unit, Radiology DepartmentReina Sofia HospitalCordobaSpain
  3. 3.MR Unit, DadisaCádizSpain
  4. 4.MR Unit, ResaltaSan Juan De Dios HospitalCordobaSpain
  5. 5.Department of RadiologyUniversity of Texas M.D. Anderson Cancer CenterHoustonUSA

Personalised recommendations