Table 2.

Typical imaging findings of different benign cardiac masses on multimodality imaging

Imaging modality	Myxoma	Fibroma	Lipoma	Papillary fibroelastoma	Rhabdomyoma
Echocardiography	-Hyperechoic -Well defined mobile mass attached to endocardial surface by a stalk	-Distinct and well demarcated -Hyperechoic -Homogenous -Myocardially embedded, noncontractile -Calcified flecks centrally	-Hyperechoic within cardiac chambers (if located ​pericardial space = hypoechoic) -Broad-base, usually immobile	-TEE more sensitive -Usually mobile -Smaller in size, stippled borders due to vibration at blood-tumor attachment interface	-Small, well circumscribed solid hyperechoic masses -can mimic diffuse myocardial thickening
Cardiac Computed Tomography	-Decreased attenuation -Calcified attenuating areas (40-100 HU), more common in right sided mass -Intracavitary	-Variable attenuation depending on contrast timing (usually low attenuation) -Homogenous -Intramurally located -Calcified -Infiltrative/sharp demarcation -Non contrast enhancing	-Homogeneous -Hypoattenuation, resembling surrounding mediastinal adipose tissue (∼-100 HU)	-Hypoattenuating mass with irregular borders	-Intramural lesion -Variable attenuation -No calcification -Mild contrast enhancement
Cardiac Magnetic Resonance Imaging	-Heterogenous LGE update -T1: Isointense -T2: Hyperintense ∗T1/T2 can heterogenous due to varying amounts of myxoid, hemorrhagic, ossific, and necrotic tissue	-Hypointense in areas of calcium -Minimal/no LGE -T1: Isointense -T2: Hypointense	-No LGE -T1: Hyperintense -T2: Hyperintense	-LGE: Variable, usually absent -T1: Isointense -T2: Variable (can be hypointense if high fibrous content)	-No/minimal LGE -T1: Isointense -T2: Iso/hyper-intense

LGE, late gadolinium enhancement; TEE, transesophageal echocardiography.