Table 1 CMR imaging characteristics of various types of cardiac masses
From: Society for Cardiovascular Magnetic Resonance 2019 Case of the Week series
| Tumor | Common location | T1 weighted | T2 weighted | T1 post contrast enhancement | Late gadolinium enhancement | Fat suppression |
|---|---|---|---|---|---|---|
| Pseudotumors | ||||||
| Thrombus | Atrial appendage in valve disease and/or atrial fibrillation; Ventricles related with aneurysm or myocardial infarction | Hypointense (hyperintense if acute or subacute) | Hypointense (hyperintense if acute) | No | Hypointense with long TI time | No change |
| Pleuro-pericardial cyst | Right cardiophrenic angle is the most common; can be anywhere in mediastinum | Hypointense; can be hyperintense if hemorrhagic | Hyperintense | No | Hypointense | No change |
| Vegetation | Cardiac valves and aortic grafts | Frequently not visible | May be visualized if large | Can enhance | Can enhance (if wide based and large | No change |
| Benign Cardiac Tumors | ||||||
| Myxoma | Left atrium Fossa ovalis | Variable | Variable | Yes | Heterogeneous | No change |
| Lipoma | Any chamber, intramyocardial or intracavitary | Hyperintense | Hyperintense | No | Hypointense | Hypointense (signal dropout) |
| Papillary fibroelastoma | cardiac valves | Isointense | Hyperintense | Yes | Hyperintense | No change |
| Rhabdomyoma | Any chamber, intramyocardial or intracavitary | Isointense | Hyperintense | Yes | Isointense | No change |
| Fibroma | Intramyocardial (ventricular septum or free wall) | Isointense | Hypointense | Hypointense core; Isointense periphery | Hyperintense | No change |
| Hemangioma | Ventricles intramyocardial / intracavitary | Intermediate | Hyperintense | Yes | Variable | No change |
| Malignant Cardiac Tumors | ||||||
| Angiosarcoma | Right atrium, pericardial and myocardial invasion | Heterogeneous | Heterogeneous | Heterogeneous | Heterogeneous | No change |
| Rhabdomyosarcoma | Any chamber; pericardial or pleural involvement | Intermediate | Hyperintense | Variable | Heterogeneous | No change |
| Lymphoma | Pericardial effusion; Intracardiac masses (mostly involves the right heart) | Isointense | Isointense to Hyperintense | Variable | Variable | No change |
| Metastases | Multiple lesions, mostly involves the right heart, pericardial effusion | Hypointense | Hyperintense | Variable | Heterogeneous | No change |