Fig. 4.

T1-weighted double inversion recovery four-chamber image of heart in 47-year-old man shows large epicardial mass adjacent to left ventricular lateral wall, which was metastasis from known germ cell tumor. Utility of high-resolution T1-weighted double inversion recovery imaging is high spatial resolution that allows determination that epicardial fat has not been invaded by tumor (arrow). When there is doubt, adding tagging sequences (Fig. S4, cine loop in supplemental data online) may better depict whether there is independent motion of a mass from myocardium.