Magnetic resonance imaging in the detection of a large left atrial myxoma Burkhard Sievers, MD, Dirk Fritzsche, MD, Regina Bias-Franken, MD, Ulrich Franken,

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Presentation transcript:

Magnetic resonance imaging in the detection of a large left atrial myxoma Burkhard Sievers, MD, Dirk Fritzsche, MD, Regina Bias-Franken, MD, Ulrich Franken, MD, Hans-Joachim Trappe, MD The American Journal of Medicine Volume 115, Issue 2, Pages 155-157 (August 2003) DOI: 10.1016/S0002-9343(03)00128-1

Figure 1 Cine imaging in the horizontal long-axis view (A: FLASH; B and C: TrueFISP) reveals a large tumor adjacent to the left atrial septum (arrow in A), compromising the mitral valve and prolapsing into the left ventricle during ventricular end-diastole (C, arrows indicate the level of the mitral valve annulus during ventricular end-diastole). The tumor location during systole is shown in B (arrows indicate the level of the mitral valve annulus during ventricular end-systole). The short-axis view (D) shows the typical lobulated structure of the myxoma (arrow). Prolapse of the myxoma through the mitral valve into the left ventricle during diastole is shown in E (arrows indicate the level of the mitral valve anulus). F: Contrast-enhanced magnetic resonance imaging using gadolinium-DTPA (single shot segmented turbo FLASH) demonstrates no late enhancement of the tumor (arrow), indicating muscle tissue (image acquired in ventricular diastole), with the myxoma of the same signal intensity as the myocardium. DTPA = gadopentate dimeglumine; FISP = fast gradient-echo imaging with steady-state free precession; FLASH = fast low-angle shot. The American Journal of Medicine 2003 115, 155-157DOI: (10.1016/S0002-9343(03)00128-1)

Figure 2 Lobulated gelatinous tumor in situ (A, arrow) and after extirpation (B). The American Journal of Medicine 2003 115, 155-157DOI: (10.1016/S0002-9343(03)00128-1)

Figure 3 A noninfiltrating atrial myxoma with a narrow base resting on the endocardium is seen in sections stained by hematoxylin and eosin (A) and the elastica van Gieson stain (B). The tumor is composed of a myxoid stroma containing cells that are spindle shaped to stellate and that vary slightly in size. There are numerous vessels, some of which are thick walled. There are also areas of sclerosis and hemorrhages of varying ages. A narrow subendocardial zone of fibrosis can also be seen. Reprinted with permission from Ute Raute-Kreinsen, MD, Institute of Pathology, Städtische Kliniken, Bielefeld, Germany. The American Journal of Medicine 2003 115, 155-157DOI: (10.1016/S0002-9343(03)00128-1)