Figure 2

Imaging of cardiac metastases. Images from a patient with lung cancer with pericardial metastases. Panel A shows an axial slice of the heart acquired by steady-state free precession imaging. The red arrows point to the circumferential pericardial mass, which is hypointense and encases the entire right atrium, right ventricle and left ventricle. Panel B shows a cine image of the pericardial mass in a short-axis orientation (an additional movie file shows the cine series in motion [see Additional file 1]). In addition to the circumferential extent of the mass, the anterolateral wall of the left ventricle and the free wall of the right ventricle are tethered to the mass with reduced wall thickening and motion (arrows). Panel C shows a T2 weighted image in the same short-axis orientation. The red arrows point to the hyperintense mass. Panel D shows a delayed enhancement image of the mass in the short axis orientation. The red arrow points to the areas of hyperenhancement within the mass. The blue arrow points to the necrotic areas within the mass which are hypoenhanced with low signal intensity.