Electronic ISSN 2287-0237

VOLUME

THE ATRIAL MYXOMA, THE LEARNING MODEL FOR CARDIAC TUMOR ASSESSMENT USING MAGNETIC RESONANCE IMAGING: A CASE REPORT

SEPTEMBER 2015 - VOL.10 | CASE REPORT

Cardiac tumor is still considered as the one of the most difficult conditions in cardiology in terms of diagnosis and treatment. The atrial myxoma is a common primary benign cardiac tumor presenting in adults.1 The diagnosis of cardiac tumor always relies on the clinical examination and results obtained from the imaging tools used. This article selects the atrial myxoma as a learning model to demonstrate the assessment of the cardiac tumor when using Magnetic Resonance Imaging (MRI) with the different techniques including the tissue characterization method which has already been established as a key diagnostic method for the diagnosis of cardiac tumor and mass.

Keywords

cardiac tumor, atrial myxoma, tissue characterization, MRI

DOI:

10.31524/bkkmedj.2015.09.009

MEDIA
Figure A: The gradient echo CINE MRI image demonstrates the left atrial mass (*) atrial myxoma with two stalks that attaches to the left side of the inter-atrial septum (black arrow).
The myxoma produces heterogeneous hypointensity among the iso intensity (to myocardium) background (▲).
Figure B: The left atrial tumor mass (atrial myxoma) with stalk is demonstrated on the gradient echo CINE MRI (*) on the short axis view of the atrium. The mass attaches to the left side of the inter-atrial septum (white arrow).
Figures C, D: The left atrial myxoma (*) with stalk is demonstrated on T1W and T2W bb spin echo images on the short axis view of the atrium.
Figure C: The left atrial myxoma produces heterogeneous hypo- and iso intensity in the T1W bb and produces heterogeneous hypo - and iso intensity that and produces heterogeneous hypo- hyper and iso intensity on the T2W bb images (Figure D). Probable some chronic hemorrhage in the tumor is suggested by the evidence of hypo-intensity that is produced by the same area in the tumor and is visualized on both T1W and T2W bb spin echo images.
Figure E: The T2W bb with fat saturation demonstrates the hyperintensity of the mass (arrow) on the isointense background that is compatible with the hyperintense area on T2W bb that indicates an area of fluid.
Figure F: The first pass contrast injection study reveals no contrast perfusion into the tumor mass (*) and this indicates no hypervasularization of tumor mass.
Figure G: The delayed contrast enhancement study reveals contrast enhancement of the left atrial myxoma at the central area (*) and this indicates tissue necrosis of tumor mass
and the prominent minimal hypo-enhancement area may indicate a hemosiderin or calcium (white arrow).
Figure H: The delayed contrast enhancement study reveals an heterogeneous contrast enhancement of the tumor (*) and this indicates some necrotic tissue of the tumor
and the inhomogenous hypo-enhancement of the tumor that indicates a hemosiderin or calcium.
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