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. 2021 Nov 26;13(11):628–649. doi: 10.4330/wjc.v13.i11.628

Table 1.

Cardiovascular magnetic resonance characteristic (location, signal intensity and contrast contrast-enhanced relative to that of adjacent normal myocardium) of benign and malignant cardiac masses

Lesion
Location
T1-WI
T2-WI
Cine-SSFP
Perfusion
EGE
LGE
Non-neoplastic
Thrombus Acute/subacute Mural or intraluminal Iso-Hyper Iso-Hyper Iso-hypo No enhancement No enhancement Hypointense border and brighter central zone
Thrombus Chronic Mural or intraluminal Hypo Hypo Iso-hypo Rare No enhancement Rarely heterogeneous
Pericardial cyst Right cardiophrenic angle Hypo Hyper Hyper No enhancement No enhancement No enhancement
Mitral annular calcification Annular fibrous ring of the left atrio-ventricular valve Hypo Hypo Iso-hypo No enhancement Peripheral rim of enhancement Peripheral rim of enhancement
Liquefaction necrosis Annular fibrous ring of the left atrio-ventricular valve Mildly Hyper Mildly Hyper Iso-hypo No enhancement Peripheral rim of enhancement Peripheral rim of enhancement +/- core enhancement
Neoplastic - Benign
Myxoma Left atrium, arising from the interatrial septum Iso (heterogeneous) Hyper (heterogeneous) Hypo Heterogeneous Heterogeneous Heterogeneous
Papillary fibroelastoma Atrial side of the mitral valve and the aortic surface of the aortic valve leaflet Iso Iso Hypo Usually not assessable Mild and homogeneous or no enhancement Homogeneous or no enhancement
Lipoma Atrial septum and epicardium, but it may occur anywhere in the heart Hyper Hyper (Hypo on STIR images) Hyper (with black boundary artifact or India ink artifact) No enhancement No enhancement No enhancement
Hemangioma Every cardiac chamber and also from pericardial space Iso Hyper Hyper Heterogeneous, intense and prolonged Homogeneous or heterogeneous Homogeneous or heterogeneous
Fibroma Intramural growth in the ventricles (interventricular septum or the ventricular free wall) Iso Hypo Iso-hypo Mild and homogeneous Mild and homogeneous No enhancement or minimal uptake
Rhabdomyoma Intramyocardial or intracavitary, with intraventricular growth that may cause outflow obstruction Iso Mildly Hyper Iso-hypo No enhancement or minimal uptake No enhancement or minimal uptake No enhancement or minimal uptake
Cardiac teratomas Intrapericardial (usually compressing superior vena cava and/or right atrium) Iso or Hypo Hyper Iso or Slightly hyper No enhancement Mild and heterogeneous Heterogeneous
Paraganglioma On the roof of left atrium Iso-Hypo with “salt and pepper” appearance Hyper with “salt and pepper” appearance Hyper Strong enhancement Heterogeneous Peripheral Heterogeneous Peripheral
Neoplastic - malignant: Primary cardiac tumor
Angiosarcoma Right atrium close to atrio-ventricular sulcus Iso-Hyper (heterogeneous) Hyper (heterogeneous) Iso (heterogeneous) Strong enhancement Marked and Heterogeneous Marked and Heterogeneous
Leiomyosarcoma Typically involve the left atrium Iso Iso-Hyper Iso Heterogeneous, intense Marked and Heterogeneous Marked and Heterogeneous
Rhabdomyosarcoma Multiple masses and there is not any predilection in terms of cardiac structures involved Iso Iso-Hyper (hyper on STIR images) Iso Heterogeneous, intense Marked and Heterogeneous Marked and Heterogeneous
Lymphoma Right chambers, often right ventricle and are associated with pericardial effusion Hypo-Iso Mildly Hyper (more evident on STIR images) Iso Mild Heterogeneous No or progressive mild heterogeneous enhancement
Mesothelioma Pericardium Iso Hyper (heterogeneous) Iso Progressive enhancement Intense enhancement Intense enhancement
Malignant - Malignant: metastatic disease Mainly involve myocardium and pericardium Low (except for Melanoma which is Hyper) Hyper Iso Heterogeneous Heterogeneous Heterogeneous

T1-WI: T1-weighted images; T2-WI: T2-weighted images; STIR: Short tau inversion recovery; Cine-SSFP: Cine-steady state free precession; EGE: Early gadolinium enhancement; LGE: Late gadolinium enhancement; Hypo: Hypointense; Iso: Isointense; Hyper: Hyperintense.