Interpretation of cardiac masses according to updated 2021 WHO tumor classification: a retrospective MRI study
Abstract Background and purpose Although cardiac tumors are rare, their accurate diagnosis and interpretation is mandatory to set a correct line of management which is mainly surgical. This study aimed to interpret cardiac magnetic resonance imaging (CMRI) findings of cardiac masses according to the...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-07-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-025-01543-9 |
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| Summary: | Abstract Background and purpose Although cardiac tumors are rare, their accurate diagnosis and interpretation is mandatory to set a correct line of management which is mainly surgical. This study aimed to interpret cardiac magnetic resonance imaging (CMRI) findings of cardiac masses according to the 2021 WHO classification of cardiac tumors. Methods CMRI examinations performed for patients with a suspected cardiac mass were retrospectively reviewed in the period from January 2019 to June 2024. 59 patients with cardiac masses were found, their median age was 28.5 years. Cardiac masses were characterized according to their location, largest dimension in millimeters, pre-contrast visualization, signal on T1, T2, fat suppression, mobility on steady state free precession (SSFP) cine sequences, first-pass perfusion (FFP) and late Gadolinium enhancement (LGE) sequences, possibility of invasion of adjacent structures and associated pericardial effusion and categorized as pseudo-tumor (thrombus), benign and malignant neoplasms. The validity of CMRI parameters for differentiation of thrombus from tumors and differentiation of benign from malignant tumors was evaluated. In (52, 88.1%) patients, the CMRI findings were compared to histopathology, while (7, 11.9%) patients had 1.5 year follow up. Results A study with 59 patients, (38, 64.4% males). (13, 22%), (8, 13.6%), (7, 11.8%), (9, 15.3%), (10, 16.9%), (8, 13.6%) were in the right atrium (RA), right ventricle (RV), left atrium (LA), left ventricle (LV), valvular, and involving multiple chambers respectively. (40, 67.8%) were single, while (19, 32.2%) were multiple. (42, 71.2%) were non-mobile. The lesions were visualized on pre-contrast sequences in (54, 91.5%) and were invasive in (19, 32.2%) patients. (7, 11.9%) patients showed associated small amount of pericardial effusion and (5, 8.5%) had associated moderate amount. (21, 35.6%) of the cases were pseudo-tumor, (25, 42.4%) cases were benign tumors, while (13, 22%) cases were malignant. The accuracy of LGE in differentiating thrombus from tumors was 77.97%, while it was 92.11%, 86.9% and 78.95% for mean diameter, invasion of adjacent structures and homogeneity for differentiating benign from malignant tumors respectively. Conclusions CMRI is an important imaging modality that is highly accurate in characterization and interpretation of cardiac masses. It is useful to link the interpretation of cardiac masses on MRI to the updated 2021 WHO Tumor Classification. |
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| ISSN: | 2090-4762 |