[MRI diagnosis of cardiac myxomas: sequence evaluation and differential diagnosis].
OBJECTIVE
To evaluate native and contrast enhanced T1-weighted spin (T1-SE), cine gradient echo (Cine-GE), and T2-weighted turbo spin (T2-TSE) sequences in the diagnosis and differential diagnosis of cardiac myxomas.


METHODS
15 patients with echocardiographically suspected cardiac atrial myxomas underwent 0.5 T-MR imaging of the heart with native T1-SE, contrast-enhanced T1-SE, Cine-GE, and T2-TSE sequences. MR images were evaluated for signal intensity (SI) and lesion's conspicuity. Results were confirmed histologically (14 x) or by follow-up (1 x).


RESULTS
MRI revealed myxomas in 9 patients, sarcomas in three patients, and thrombi in three patients. Lesion conspicuity was better in Cine-GE and T2-TSE compared with native and contrast-enhanced T1-SE sequences. Myxomas were characterized by an intermediate SI similar to myocardium in T1-SE, high SI similar to water in T2-TSE, and low to moderately high enhancement (range 19-75%, mean 48%).


CONCLUSIONS
Distinct SI characteristics together with anatomical-topographical features (attachment to the interatrial septum, no infiltration of myocardium and vessels) are diagnostic for cardiac myxomas. Cine-GE and T2-TSE sequences are the sequences of choice for detection of myxomas and other atrial masses. T2-TSE and contrast-enhanced T1-weighted sequences are most useful for mass characterisation and differentiation between myxomas, malignant tumors, and thrombi.
Sommer
T
T
Radiologische Universitätsklinik Bonn.
Vahlhaus
C
C
Hofer
U
U
von Smekal
A
A
Wardelmann
E
E
Bierhoff
E
E
Pauleit
D
D
Wilhelm
K
K
Textor
J
J
Schild
H
H
D003937:Diagnosis, Differential; D006325:Heart Atria / Q000473:pathology; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006346:Heart Septum / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D009206:Myocardium / Q000473:pathology; D009232:Myxoma / Q000175:diagnosis* / Q000473:pathology; D012509:Sarcoma / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000175:diagnosis / Q000473:pathology