Dana Dawson, Raad Mohiaddin Progress in Cardiovascular Diseases

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Assessment of Pericardial Diseases and Cardiac Masses with Cardiovascular Magnetic Resonance Dana Dawson, Raad Mohiaddin Progress in Cardiovascular Diseases Volume 54, Issue 3, Pages 305-319 (November 2011) DOI: 10.1016/j.pcad.2011.08.001 Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 1 Serial short axis view of SSFP, T1W-TSE, T2W-TSE with fat suppression, early and late after gadolinium administration (A to E, respectively), demonstrating thickening of both pericardial layers with a small pericardial effusion. Note that pericardium enhances with contrast. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 2 Large pericardial effusion (asterix) seen on SSFP images of 4-chamber view, 3-chamber view and short axis (A-C) and late after gadolinium administration (D). Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 3 (A) Global thickening of the pericardium (arrows) seen in transverse (A) and short-axis (B) T1-W Turbo spin-echo images and also on the corresponding SSFP images (c-d). Note the bilateral pleural effusions. (B) Functional assessment of ventricular inter-dependence: a shows a normal septal position during expiration and b demonstrates a marked leftward septal shift seen immediately after deep inspiratory effort. White arrows demonstrate the relative change in cavity size due to the septal shift. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 4 A-B, SSFP images of a large pericardial cyst located in the right costophrenic angle (arrows); (C) T1W-TSE and (D) T2W-TSE with fat suppression demonstrating the cystic mass. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 5 A-B Turbo spin-echo image and C-D: SSFP image of total pericardial absence, which shows as a shift of the entire heart to the left and enlargement of the right heart. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 6 A-B SSFP images of a left atrial myxoma attached to the inter-atrial septum; C-D late gadolinium enhancement images showing enhancement of the core of the tumour with contrast. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 7 A well-circumscribed mass (arrow) is seen in the right atrium with high signal intensity on T1W-TSE images (A) and suppressed signal on T2-W TSE with fat suppression (B). Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 8 Small mass attached to the tricuspid valve seen in a SSFP image (A), with high signal intensity on a T2W-TSE (B) and markedly enhancing on the late gadolinium enhanced images (C-D). Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 9 Large intramyocardial mass located within the interventricular septum of similar signal intensity to the myocardium seen on SSFP images (A) and significant late gadolinium retention denoting an increased volume of distribution (B). C shows the specimen after surgical resection. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 10 Large mass with irregular edges (arrows), occupying the back of the right atrium, extending beyond the borders of the heart with destruction of the myocardial walls (white arrows) seen on HASTE images (A), enhancing with contrast after gadolinium administration (B), showing an inhomogenous signal intensity on T1W-TSE (C) and also seen on SSFP images. A large, hemorrhagic pericardial effusion is also seen. Histology demonstrated an angiosarcoma. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 11 Multiple masses present in the myocardium, with irregular borders and local invasion extramyocardially (arrows), seen on T1W-TSE (A), T2W-TSE, enhancing variably with contrast after gadolinium administration (C). The histology later demonstrated an aggressive T-cell lymphoma (D). Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig 12 Metastatic right renal cell carcinoma. Coronal (A) and transverse (B) spin-echo image showing large right sided mass invading the inferior vena cava and extending into the right atrium (arrows). ra indicates right atrium; la, left atrium; rv, right ventricle; lv, left ventricle. Progress in Cardiovascular Diseases 2011 54, 305-319DOI: (10.1016/j.pcad.2011.08.001) Copyright © 2011 Elsevier Inc. Terms and Conditions