Table 2.
Differential Diagnosis table for cardiac metastases of melanoma [3].
| Characteristics | Uni-/multifocal | CT | MRI | |||
|---|---|---|---|---|---|---|
| T1w | T2w | CE | ||||
| Cardiac melanoma metastasis | Multifocal cardiac masses +/− pericardial effusion | Multifocal | Body staging | Hyper | Hypo | Diffuse and avid |
| Thrombus | Intracavitary | Uni- or multifocal | Filling defect after CA injection | Hyper (if new), Hypo (if organized) | Hyper (if new), Hypo (if organized) | No |
| Pericarditis | Possible nodularity and thickening of the pericardium | Uni- or multifocal | Enhancement of thickened pericardium | Hypo | Hyper | Yes |
| Fibroma | Homogeneous soft-tissue mass, marginated or infiltrative | Unifocal | Calcifications are common | Iso | Hypo | Usually no |
| Primary malign tumor | Thickening and deformation of the myocardium | Uni- or multifocal | Often low-attenuated mass, irregular or nodular | Variable | Variable | Yes |
| Bronchogenic carcinoma (cardiac involvement) | Frequently by direct extension | Unifocal | Must be suspected when CT or MRI demonstrates obliteration of the superior pulmonary vein | |||
| Breast cancer metastasis | Myocardial and/or pericardial mass | Multifocal | Low attenuation mass | Hypo | Hyper | Yes |
| Lymphoma | No regional predilection | Focal | Irregular thickening of the walls, hypo/iso-attenuated | Iso | Hyper | Yes |
| Osteosarcoma (cardiac involvement) | Metastases contain bone | Focal | Calcific areas of increased opacity | Hypo/iso | Iso/hyper | Yes |
CT: computed tomography, MRI: magnetic resonance imaging, T1w: T1 weighted, T2w: T2 weighted, CE: contrast enhancement, hyper: hyperintense signal, hypo: hypointense signal, iso: isointense signal, CA: contrast agent