MRI and pathologic correlation of cardiac myxomas / 中华放射学杂志

ABSTRACT

Objective To investigate the MRI features of cardiac myxoma by correlated with its pathological findings. Methods MRI features of 22 cases of pathologically confirmed cardiac myxomas were retrospectively reviewed. Results Of 22 cases, 21 are solitary, 12 located in left atrium, 6 located in right atrium, 2 located in left ventricle and 1 located in right ventricle. The other one occupied multiple chambers. MRI: 19 are heterogeneous and 3 are homogeneous. Cine-MRI: 18 attach to the endocardium with a pedunculated stalk and 4 are sessile and with a broad attachment. Thirteen cases had secondary valve insufficience or stenosis. Nine have compromised cardiac function. Nineteen cases demonstrated mild to moderate heterogeneous enhancement after Gd-DTPA administration and 3 ease showed no enhancement. Four cases had gadolinium first-pass perfusion study and showed a slow and continuous increasing time-intensity, lower than normal myocardium. The pedicles and wall showed delay enhancement. Pathologic findings: 21 are oval and lobalar configuration, 1 is grape-like. Ten cases had fresh hemorrhage and 5 had chronic hemorrhage. Fourteen had necrosis , 2 had cystic change and 4 had calcification. Blood vessels or inflanmmtory cells could be detected in 19 cases. Conclusions MRI can evaluate the size, location, morphology, especially the vascularity, histologic features and cardiac function of cardiac myxomas.