Role of MRI in evaluation and characterization of neoplastic and nonneoplastic cardiac masses

Abstract

BackgroundThe overall frequency of cardiac tumors is quite low, with an estimated cumulative prevalence of 0.002–0.3% at autopsy, however, they represent an important group of cardiovascular abnormalities as the early and accurate diagnosis maybe curative and sometimes avoids unnecessary surgery.Aim and objectivesThe aim of this study was to evaluate the efficacy of MRI, in diagnosis, evaluation, and characterization of cardiac neoplasms, as identification and differentiation between the cardiac masses are of extreme importance to develop exquisite better therapeutic planning and positive prognostic results.Patients and methodsThis study is a prospective one that was conducted on 27 patients who were diagnosed to have cardiac masses by echocardiography or other imaging modalities. Contrast-enhanced MRI was done on closed Siemens MR Systems operating at 1.5 T in National Heart Institute in Giza. The study was performed after approval of the Ethical Committee of Scientific Research. Evaluation of cardiac masses was analyzed, regarding the involved chambers, pericardial violation, morphological characters, as well as their pattern of enhancement at contrast-enhanced cardiac MRI studies, aiming at characterization of different cardiac masses on MRI diagnostic bases.ResultsIn our study, we diagnosed 85.2% (23/27) of the cases as benign-looking lesions (including both true and pseudotumors), while 14.8% (4/27) as malignant-looking lesions. A statistical significant difference was noted, regarding the differentiation between the benign and the malignant lesions regarding the size, marginal outline, pattern of growth, and pericardial affection, either infiltration or effusion. As regards the pericardial affection, none of the benign lesions showed pericardial infiltration compared with 50% (2/4) of the malignant lesions that showed pericardial infiltration with a statistically significant P value of 0.017.ConclusionCardiac magnetic resonance imaging (CMR) has a great role in evaluation of the cardiac masses by its powerful assessment of the anatomical and soft-tissue characterization of the masses, as well as their functional impact, and so it allows the differentiation between neoplastic and nonneoplastic masses, as well as between malignant and benign masses.