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409 Case study: left atria mass evaluation with hyper-enhancement imaging
Journal of Cardiovascular Magnetic Resonance volume 10, Article number: A123 (2008)
A 58 year old woman was referred for functional and contrast enhanced cardiovascular magnetic resonance (CMR) scan to evaluate a left atria mass reported on echocardiogram. The patient had history of atypical chest pain and prior breast cancer.
Evaulation of left atria mass possible wall attachment and tissue chacterization
Cardiac MR was performed on a 1.5 T, Philips Achieve, using a 5-element phased-array surface coil. Survey images revealed an abnormal structure near the left atrial inferior wall. Basic functional CMR views were performed to demonstrate the mass orientation. The optimal imaging plane, short axis, was selected for T1 and T2 weighted dual inversion recovery black blood (dualIR) images with and without fat suppression were acquired to characterize the tissue of the abnormal mass. Cine CMR images (steady state free precession sequence) demonstrated the mass attached to the inferior septal wall. Perfusion study of the atria in short axis plane was performed with 8 ml of gadolinium with rate of 5 ml/sec. No perfusion of the mass was seen. An additional injection of 32 ml of gadolinium at a rate of 1 ml/sec was performed. Post T1 dualIR images noted no enhancement of the mass. Post 3D hyper-enhancement in multiple planes was performed No hyper-enhancement was observed on the delayed enhancement (segmented inversion recovery fast gradient echo sequence images).
The mass is globutated with a necrotic center and surrounded with fluid. No enhancement of the mass with gadolinium, no perfusion to the mass or hyper-enhancement. Subsequently, the mass was removed and biopsy results are pending.
CMR is an excellent tool to evaluate abnormal heart structures and characterize myocardial tissue none invasively. The ability to use multiple planes with high resolution plus image surrounding structures enables CMR to eliminate obstacles inherent in echocardiography.
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Watkins, M.P., Donahue, T., Brown, P.A. et al. 409 Case study: left atria mass evaluation with hyper-enhancement imaging. J Cardiovasc Magn Reson 10, A123 (2008). https://doi.org/10.1186/1532-429X-10-S1-A123
- Cardiovascular Magnetic Resonance
- Steady State Free Precession
- Cardiovascular Magnetic Resonance Image
- Multiple Plane
- Atypical Chest Pain