title: First experiences with contrast-enhanced first-pass MR perfusion imaging in patients with primary, benign cardiac masses and tumour-like lesions.
abstract: The aim of this study was to evaluate the diagnostic value of contrast-enhanced first-pass perfusion MRI in patients with suspected cardiac masses and tumour-like lesions. Twenty patients underwent contrast-enhanced first-pass saturation-recovery steady-state-free-precession perfusion MRI in addition to clinical MRI. Eleven diagnostic parameters were analysed blinded in consensus by three observers: localisation (paracardiac/mural/intracavitary), malignancy (benign/malignant) and first-pass enhancement pattern (homogeneous/heterogeneous as well as non-perfused/hypoperfused/iso-perfused/ hyperperfused). The results were compared to combined references comprising histology, cytology, medical and surgical reports, echocardiography, chest X-ray, coronary angiography and regular MRI. Also, we analysed if additional first-pass perfusion confirmed, changed or reduced the number of differential diagnoses compared to clinical MRI. All cardiac masses or tumour-like lesions were correctly localised and scored as benign lesions. For homogeneous perfused lesions the sensitivity, specificity, positive and negative predictive value was 94/100/100/67%, 100/94/67/100% for heterogeneous perfused lesions, 92/100/100/88% for non-perfused, 100/94/75/100 for hypoperfused, 100/100/100/100% for hyperperfused and for isoperfused lesions. In 17/2/1 cases perfusion MRI confirmed, reduced or increased the number of potential differentials. First-pass perfusion MRI provides valuable information in patients with benign cardiac masses or tumour-like lesions. Further experience is needed to underline these preliminary observations.
authors.affiliation: Department of Cardiovascular Imaging at Alice-Hospital, Darmstadt Radiology, Dieburger Strasse 29-31, 64287, Darmstadt, Germany. mohrs@radiologie-darmstadt.de
authors.forename: Oliver K
authors.initials: OK
authors.lastname: Mohrs
authors.forename: Thomas
authors.initials: T
authors.lastname: Voigtlaender
authors.forename: Steffen E
authors.initials: SE
authors.lastname: Petersen
authors.forename: Matthias
authors.initials: M
authors.lastname: Zander
authors.forename: Thomas
authors.initials: T
authors.lastname: Schulze
authors.forename: Anselm
authors.initials: A
authors.lastname: Pottmeyer
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006338:Heart Neoplasms / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D055425:Respiratory-Gated Imaging Techniques / Q000379:methods; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA