PMID- 25129516 OWN - NLM STAT- MEDLINE DCOM- 20150528 LR - 20220410 IS - 1876-7591 (Electronic) IS - 1876-7591 (Linking) VI - 7 IP - 9 DP - 2014 Sep TI - Value of CMR for the differential diagnosis of cardiac masses. PG - 896-905 LID - S1936-878X(14)00486-0 [pii] LID - 10.1016/j.jcmg.2014.05.009 [doi] AB - OBJECTIVES: The goal of this study was to evaluate the diagnostic value of CMR features for the differential diagnosis of cardiac masses. BACKGROUND: Differentiation of cardiac tumors and thrombi and differentiation of benign from malignant cardiac neoplasms is often challenging but important in clinical practice. Studies assessing the value of cardiac magnetic resonance (CMR) in this regard are scarce. METHODS: We reviewed the CMR scans of patients with a definite cardiac thrombus or tumor. Mass characteristics on cine, T1-weighted turbo spin echo (T1w-TSE) and T2-weighted turbo spin echo (T2w-TSE), contrast first-pass perfusion (FPP), post-contrast inversion time (TI) scout, and late gadolinium enhancement (LGE) sequences were analyzed. RESULTS: There were 84 thrombi, 17 benign tumors, and 25 malignant tumors in 116 patients. Morphologically, thrombi were smaller (median area 1.6 vs. 8.5 cm(2); p < 0.0001), more homogeneous (99% vs. 46%; p < 0.0001), and less mobile (13% vs. 33%; p = 0.007) than tumors. Hyperintensity compared with normal myocardium on T2w-TSE, FPP, and LGE were more common in tumors than in thrombi (85% vs. 42%, 70% vs. 4%, and 71% vs. 5%, respectively; all p < 0.0001). A pattern of hyperintensity/isointensity (compared with normal myocardium) with short TI and hypointensity with long TI was very frequent in thrombi (94%), rare in tumors (2%), and had the highest accuracy (95%) for the differentiation of both entities. Regarding the characterization of neoplastic masses, malignant tumors were larger (median area 11.9 vs. 6.3 cm(2); p = 0.006) and more frequently exhibited FPP (84% vs. 47%; p = 0.03) and LGE (92% vs. 41%; p = 0.001). The ability of CMR features to distinguish benign from malignant neoplasms was moderate, with LGE showing the highest accuracy (79%). CONCLUSIONS: CMR features demonstrated excellent accuracy for the differentiation of cardiac thrombi from tumors and can be helpful for the distinction of benign versus malignant neoplasms. CI - Copyright (c) 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Pazos-Lopez, Pablo AU - Pazos-Lopez P AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain. FAU - Pozo, Eduardo AU - Pozo E AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. FAU - Siqueira, Maria E AU - Siqueira ME AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. FAU - Garcia-Lunar, Ines AU - Garcia-Lunar I AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain. FAU - Cham, Matthew AU - Cham M AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. FAU - Jacobi, Adam AU - Jacobi A AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. FAU - Macaluso, Frank AU - Macaluso F AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. FAU - Fuster, Valentin AU - Fuster V AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain. FAU - Narula, Jagat AU - Narula J AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. FAU - Sanz, Javier AU - Sanz J AD - The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Hospital, New York, New York. Electronic address: javier.sanz@mountsinai.org. LA - eng PT - Comparative Study PT - Evaluation Study PT - Journal Article DEP - 20140813 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 RN - 0 (Contrast Media) SB - IM CIN - JACC Cardiovasc Imaging. 2014 Sep;7(9):906-8. PMID: 25212795 MH - Adult MH - Aged MH - Contrast Media MH - Diagnosis, Differential MH - Female MH - Heart Diseases/*diagnosis/pathology MH - Heart Neoplasms/*diagnosis/pathology MH - Humans MH - *Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Retrospective Studies MH - Thrombosis/*diagnosis/pathology OTO - NOTNLM OT - benign cardiac tumor OT - cardiac mass OT - cardiac thrombus OT - cardiac tumor OT - cardiac magnetic resonance OT - diagnosis OT - malignant cardiac tumor EDAT- 2014/08/19 06:00 MHDA- 2015/05/29 06:00 CRDT- 2014/08/18 06:00 PHST- 2014/04/01 00:00 [received] PHST- 2014/05/12 00:00 [revised] PHST- 2014/05/13 00:00 [accepted] PHST- 2014/08/18 06:00 [entrez] PHST- 2014/08/19 06:00 [pubmed] PHST- 2015/05/29 06:00 [medline] AID - S1936-878X(14)00486-0 [pii] AID - 10.1016/j.jcmg.2014.05.009 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2014 Sep;7(9):896-905. doi: 10.1016/j.jcmg.2014.05.009. Epub 2014 Aug 13.