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Copyright ©The Author(s) 2021.
World J Cardiol. Nov 26, 2021; 13(11): 628-649
Published online Nov 26, 2021. doi: 10.4330/wjc.v13.i11.628
Table 1 Cardiovascular magnetic resonance characteristic (location, signal intensity and contrast contrast-enhanced relative to that of adjacent normal myocardium) of benign and malignant cardiac masses
Lesion
Location
T1-WI
T2-WI
Cine-SSFP
Perfusion
EGE
LGE
Non-neoplastic
Thrombus Acute/subacuteMural or intraluminalIso-HyperIso-HyperIso-hypoNo enhancementNo enhancementHypointense border and brighter central zone
Thrombus ChronicMural or intraluminalHypoHypoIso-hypoRareNo enhancementRarely heterogeneous
Pericardial cystRight cardiophrenic angleHypoHyperHyperNo enhancementNo enhancementNo enhancement
Mitral annular calcificationAnnular fibrous ring of the left atrio-ventricular valve Hypo HypoIso-hypoNo enhancementPeripheral rim of enhancementPeripheral rim of enhancement
Liquefaction necrosisAnnular fibrous ring of the left atrio-ventricular valve Mildly HyperMildly HyperIso-hypoNo enhancementPeripheral rim of enhancementPeripheral rim of enhancement +/- core enhancement
Neoplastic - Benign
MyxomaLeft atrium, arising from the interatrial septum Iso (heterogeneous)Hyper (heterogeneous)HypoHeterogeneousHeterogeneous Heterogeneous
Papillary fibroelastomaAtrial side of the mitral valve and the aortic surface of the aortic valve leafletIsoIsoHypoUsually not assessableMild and homogeneous or no enhancementHomogeneous or no enhancement
LipomaAtrial septum and epicardium, but it may occur anywhere in the heartHyperHyper (Hypo on STIR images)Hyper (with black boundary artifact or India ink artifact)No enhancementNo enhancementNo enhancement
HemangiomaEvery cardiac chamber and also from pericardial spaceIsoHyperHyperHeterogeneous, intense and prolongedHomogeneous or heterogeneousHomogeneous or heterogeneous
FibromaIntramural growth in the ventricles (interventricular septum or the ventricular free wall)IsoHypoIso-hypoMild and homogeneousMild and homogeneousNo enhancement or minimal uptake
RhabdomyomaIntramyocardial or intracavitary, with intraventricular growth that may cause outflow obstructionIsoMildly HyperIso-hypoNo enhancement or minimal uptakeNo enhancement or minimal uptakeNo enhancement or minimal uptake
Cardiac teratomasIntrapericardial (usually compressing superior vena cava and/or right atrium)Iso or HypoHyperIso or Slightly hyperNo enhancementMild and heterogeneousHeterogeneous
ParagangliomaOn the roof of left atriumIso-Hypo with “salt and pepper” appearance Hyper with “salt and pepper” appearance HyperStrong enhancementHeterogeneous PeripheralHeterogeneous Peripheral
Neoplastic - malignant: Primary cardiac tumor
AngiosarcomaRight atrium close to atrio-ventricular sulcus Iso-Hyper (heterogeneous)Hyper (heterogeneous)Iso (heterogeneous)Strong enhancementMarked and HeterogeneousMarked and Heterogeneous
LeiomyosarcomaTypically involve the left atrium IsoIso-Hyper IsoHeterogeneous, intenseMarked and HeterogeneousMarked and Heterogeneous
RhabdomyosarcomaMultiple masses and there is not any predilection in terms of cardiac structures involved IsoIso-Hyper (hyper on STIR images)IsoHeterogeneous, intenseMarked and HeterogeneousMarked and Heterogeneous
LymphomaRight chambers, often right ventricle and are associated with pericardial effusionHypo-IsoMildly Hyper (more evident on STIR images)IsoMildHeterogeneousNo or progressive mild heterogeneous enhancement
MesotheliomaPericardiumIsoHyper (heterogeneous)IsoProgressive enhancementIntense enhancementIntense enhancement
Malignant - Malignant: metastatic diseaseMainly involve myocardium and pericardium Low (except for Melanoma which is Hyper)HyperIsoHeterogeneousHeterogeneousHeterogeneous