title: Diagnostic Performance of Cardiac Magnetic Resonance Imaging and Echocardiography in Evaluation of Cardiac and Paracardiac Masses.
abstract: Echocardiography is the preferred initial imaging method for assessment of cardiac masses. Cardiac magnetic resonance (CMR) imaging, with its excellent tissue characterization and wide field of view, may provide additional unique information. We evaluated the predictive value of echocardiography and CMR imaging parameters to identify tumors and malignancy and to provide histopathologic diagnosis of cardiac masses. Fifty patients who underwent CMR evaluation of a cardiac mass with subsequent histopathologic diagnosis were identified. Echocardiography was available in 44 of 50 cases (88%). Echocardiographic and CMR characteristics were evaluated for predictive value in distinguishing tumor versus nontumor and malignant versus nonmalignant lesions using histopathology as the gold standard. The Wilcoxon rank-sum test was used to compare the 2 imaging methods' ability to provide the correct histopathologic diagnosis. Parameters associated with tumor included location outside the right atrium, T2 hyperintensity, and contrast enhancement. Parameters associated with malignancy included location outside the cardiac chambers, nonmobility, pericardial effusion, myocardial invasion, and contrast enhancement. CMR identified 6 masses missed on transthoracic echocardiography (4 of which were outside the heart) and provided significantly more correct histopathologic diagnoses compared to echocardiography (77% vs 43%, p <0.0001). In conclusion, CMR offers the advantage of identifying paracardiac masses and providing crucial information on histopathology of cardiac masses.
authors.affiliation: Department of Cardiology, Mount Sinai Beth Israel Medical Center, New York, New York.
authors.forename: Rima
authors.initials: R
authors.lastname: Patel
authors.affiliation: Department of Radiology, The Austin Hospital, Heidelberg, Victoria, Australia.
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Lim
authors.affiliation: Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
authors.forename: Muhamed
authors.initials: M
authors.lastname: Saric
authors.affiliation: Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York.
authors.forename: Ambika
authors.initials: A
authors.lastname: Nayar
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, New York.
authors.forename: James
authors.initials: J
authors.lastname: Babb
authors.affiliation: Department of Pathology, New York University School of Medicine, New York, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Ettel
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, New York.
authors.forename: Leon
authors.initials: L
authors.lastname: Axel
authors.affiliation: Division of Cardiology, Department of Medicine, MedStar Georgetown University Hospital, MedStar Heart Institute, Washington, DC. Electronic address: srichai@alum.mit.edu.
authors.forename: Monvadi B
authors.initials: MB
authors.lastname: Srichai
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies