Cardiovascular Magnetic Resonance Imaging for Diagnosis of Suspected Cardiac Tumours

Alfa Alfin1, Elen Sahara2, Celly A. Atmadikoesoemah2, Manoefris Kasim2.

1
Departement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret
2
Departement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia - National Cardiovascular Center Harapan Kita

Abstract.
Introduction. The overall frequency of cardiac tumors is quite low with an estimated cumulative
prevalence of 0.002%0.3% at autopsy and 0.15% in echocardiographic series.1 Cardiac magnetic
resonance imaging (MRI) is considered the reference standard technique for characterization of a
suspected cardiac mass.2
Case Illustration. A-55-years-old man was reffered to National Cardiovascular Center Harapan Kita
for evaluation of a left ventricular cardiac mass. He had one year history of dyspnea on exertion
associated with suspected coronary artery disease, and suffered hyperlipidemia. Echocardiography
revealed reduced left ventricular ejection fraction with regional wall motion abnormality and found
cardiac mass at basal inferolateral wall. Coroangiography showed normal coronary artery with slow
flow. Cardiac MRI was performed in December 2016 revealed single sharply demarcated mass,
measuring 7x7x10 mm in size, attached to the freewall left ventricle homogen hyperintensein T1 and
homogen hypointense in T2 with hyperenhancement at late gadolinium enhancement. Based on these
data we suspected that the tumor was cardiac fibroma with different diagnose as rhabdomyoma.
Discussion. Patients with cardiac tumours may present with cardiovascular relate or constitutional
symptoms, but more often than not, a cardiac mass is discover incidentally during an imaging
examination performed for an unrelated indication.3 Cardiac tumor may be categorized into primary
and secondary tumors. Of these, approximately 75% are benign and 25% are malignant. 1MRI is an
important tool in the evaluation of cardiac tumor. T1-weighted, T2-weighted, and gadolinium-
enhanced sequences are used for anatomic definition and tissue characterization, whereas cine
gradient-echo imaging is used to assess functional effects.4MRI findings of cardiacfibroma are
characteristic, withinhomogeneous isointense or slightly hyperintensesignal on T1-weighted and
hypointensesignal on T2-weighted FSE imagescompared with myocardium.1
Summary. Cardiac tumors are rare but, when present, can have devastating implications. Cardiac
MRI is becoming an established method for their further assessment of cardiac tumor, and optimal
tumor characterization may be achieved with cardiac MRI.
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