title: Evaluation of cardiac masses by CMR-strengths and pitfalls: a tertiary center experience.
abstract: Cardiovascular magnetic resonance (CMR) imaging is often considered the reference method to assess cardiac tumors. However, little data exists concerning the effectiveness of CMR for the accurate diagnosis of cardiac masses. We sought to understand the diagnostic value of CMR for evaluation of suspected cardiac mass. A total of 249 consecutive CMR cases performed at a single center from January 2005 to June 2013 for evaluation of masses found on echocardiography or computed tomography (CT) were included. All the clinical data and imaging features of these patients were retrospectively reviewed and medical records were verified for follow up care. More than half of the patients referred for evaluation of masses found at echocardiography or CT were found to have no evidence of mass by CMR. CMR correctly differentiated between thrombus and myxoma in 88.4 % cases. Malignant masses were accurately diagnosed on CMR. However, CMR missed or misdiagnosed a few cases of benign masses. Diagnosing cardiac masses remains an important use for imaging, despite technical difficulties with current imaging modalities. CMR can play a key role in confirming presence or absence of a mass. Additionally, in the presence of a mass, CMR can provide accurate differentiation of pseudomasses, benign and malignant masses. However, the limitations of CMR must be recognized.
authors.affiliation: Cardiovascular Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Department of Radiology, Global Hospitals and Research Centre, Mt Abu, Rajasthan, India.
authors.forename: Roja
authors.initials: R
authors.lastname: Tumma
authors.affiliation: Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Department of Cardiology, PLA General Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.affiliation: Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Department of Cardiology, PLA General Hospital, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Cardiovascular Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.|Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Harold
authors.initials: H
authors.lastname: Litt
authors.affiliation: Cardiovascular Division, Department of Medicine, Hospital of the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. yuchi.han@uphs.upenn.edu.
authors.forename: Yuchi
authors.identifier: http://orcid.org/0000-0001-7582-1848
authors.initials: Y
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015143:Philadelphia; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed
keywords: Cardiac mass; Cardiovascular magnetic resonance; Echocardiography; Myxoma; Thrombus
references.citation: J Assoc Physicians India. 2012 Aug;60:42
references.pmid: 23405521
references.citation: AJR Am J Roentgenol. 2011 Nov;197(5):W837-41
references.pmid: 22021530
references.citation: J Am Coll Cardiol. 2014 May 27;63(20):2170
references.pmid: 24703922
references.citation: Case Rep Oncol Med. 2013;2013:814291
references.pmid: 24194994
references.citation: Can J Cardiol. 2005 Jun;21(8):675-80
references.pmid: 16003450
references.citation: Eur Heart J. 2011 Jun;32(12):1551-60
references.pmid: 21498848
references.citation: Radiology. 1992 Jan;182(1):225-9
references.pmid: 1727287
references.citation: Eur Radiol. 2000;10 (3):443-9
references.pmid: 10756993
references.citation: Rev Esp Cardiol. 1993 Oct;46(10 ):677-9
references.pmid: 8235005
references.citation: Radiographics. 2000 Jul-Aug;20(4):1073-103; quiz 1110-1, 1112
references.pmid: 10903697
references.citation: Arq Bras Cardiol. 2013 Sep;101(3):263-72
references.pmid: 23887734
references.citation: Radiology. 2013 Jul;268(1):26-43
references.pmid: 23793590
references.citation: Clin Radiol. 2009 Dec;64(12 ):1214-30
references.pmid: 19913133
references.citation: Rev Esp Cardiol. 1993 Nov;46(11):761-4
references.pmid: 8290780
references.citation: Proc (Bayl Univ Med Cent). 2001 Oct;14(4):358-76
references.pmid: 16369647
references.citation: Circulation. 2013 Oct 15;128(16):1790-4
references.pmid: 24126323
references.citation: Lancet Oncol. 2005 Apr;6(4):219-28
references.pmid: 15811617
references.citation: Arch Pathol Lab Med. 1993 Oct;117(10):1027-31
references.pmid: 8215825
references.citation: Circulation. 2002 Dec 3;106(23 ):2873-6
references.pmid: 12460863
references.citation: Cardiology. 2001;95(1):40-7
references.pmid: 11385191
references.citation: J Radiol Case Rep. 2009;3(9):1-5
references.pmid: 22470681
references.citation: Circulation. 1998 Jun 2;97(21):2188
references.pmid: 9626182
references.citation: Cardiovasc Intervent Radiol. 2004 Sep-Oct;27(5):459-69
references.pmid: 15383848
references.citation: J Clin Imaging Sci. 2013 Aug 31;3:34
references.pmid: 24083071