Left ventricular thrombus in a 55-year-old man with a history of myocardial infarction. A mass was seen at transthoracic echocardiography, which prompted further evaluation with MR imaging. B, There was no uptake of contrast agent in the mass (arrow) at EGE imaging, which suggested it was avascular. The combination of an avascular mass overlying a regional wall motion abnormality with demonstrable infarction confirmed the diagnosis of left ventricular thrombus.(Radiology 2013;268;1:26–43) ©RSNA, 2013. All rights reserved. Printed with permission.
While most cardiac masses are initially detected with echocardiography, cardiac MR imaging is becoming an established method for further assessment by providing versatile imaging planes, superior tissue contrast and advanced tissue characterization.
In an article in the July issue of Radiology (RSNA.org/Radiology), Manish Motwani, M.B.Ch.B., of the University of Leeds, England, and colleagues provide a detailed description of a core protocol for the MR assessment of cardiac masses and tumors and illustrate the different imaging characteristics of the most common types of mass, with case examples.
Knowledge of the MR imaging features of cardiac neoplasms and other masses is important for establishing an accurate diagnosis, avoiding misinterpretation of normal variants, and staging, directing appropriate therapy and evaluating prognosis in confirmed tumors, according to the authors.
“Cardiac MR imaging features reliably detect thrombus and have been shown to accurately differentiate between benign and malignant tumors,” the authors write. “A core protocol of MR sequences as described in this review allows the morphology, anatomy, tissue characteristics, and functional impact of a suspected tumor to be assessed in a single examination.”
Right-sided sacroiliitis. Color map from computer-assisted diagnostic analysis of dynamic contrast-enhanced MR imaging data clearly depict the areas in which the ROIs were placed.(RadioGraphics 2013;33) ©RSNA, 2013. All rights reserved. Printed with permission.
MR imaging is the most recent innovation and important change with respect to the previously established classification criteria for axial spondyloarthropathy. Along with serving as a biomarker of disease activity, MR imaging allows monitoring and provides guidance for the treatment of affected patients.
As MR imaging becomes more central to caring for these patients, familiarity with the anatomy, anatomic variants and physiologic changes of the sacroiliac joints is important for correctly interpreting findings and avoiding misdiagnosis, according to an article in the July-August issue of RadioGraphics (RSNA.org/RadioGraphics), by María Navallas, M.D., of the IDIMAR CRC Mar–Hospital del Mar, Barcelona, Spain. Specifically, the authors discuss:
MR imaging has become the new biomarker of disease activity because of its capacity to help detect inflammatory changes, even in advanced stages in which ankylosis of the sacroiliac joint has emerged, according to the authors.
“More important, MR imaging is able to help quantify inflammatory activity, which makes it ideal for monitoring disease activity and for guiding treatment of sacroiliitis,” the authors write.
The article is accompanied by two invited Commentaries.
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