2012 Usefulness of First Pass Dynamic Contrast-Enhanced MRI for evaluation of Cardiac Tumors

 

Usefulness of First Pass Dynamic Contrast-Enhanced MRI for evaluation of Cardiac Tumors

 

*Ho NamKoong, RT, **Eun-Ah Park, MD

*Department of Radiology, Seoul National University Hospital

**Department of Radiology, Seoul National University College of Medicine

 

I. Purpose: Pre- and Post-, and delayed-enhancement MR imaging are used for anatomic definition and tissues characterization in cardiac tumors. In addition, the first pass dynamic contrast-enhanced (DCE) MRI possibly allows an even more comprehensive evaluation of tumor perfusion. This sequence is applied for evaluation of myocardial perfusion. We investigated that time-intensity curves can enable semi-quantitative analysis of perfusion patterns of different cardiac tumors and also those cine images can show blood flow surrounding tumors.

 

II. Materials & Methods: We reviewed retrospectively a total of 28 cardiac MRI examinations in 19 patients (10 males, 9 females, mean age; 46.6 years old) from March 2010 to September 2011. First pass dynamic T1-weighted with ECG triggering (Turbo FLASH with non-selective Saturation Recovery) was applied in 1.5T Scanner (Magnetom Sonata, Siemens, Germany) during intravenous administration of 0.2mmol gadolinium-diethylenetriaminepentaacetic acid (DTPA) per kilogram of body weight and 25ml of saline flushing with 4ml/sec of flow rate. Scanning parameters were as follows; TR/TE= 174/0.96ms, flip angle=15 degree, field of view=300-350mm, matrix=128 x96. First pass DCE sequence was performed in 20 of 28 examinations. Time-intensity curve was calculated from all different cardiac tumors and all images were reviewed by a well-experienced radiological technologist and a cardiovascular specialized radiologist.

 

III. Results: Cardiac tumors were a lipoma and three fibromas in benign, two angiosarcomas, an osteosarcoma, two lymphomas, and three metastatic involvements in malignancy, and four throumbuses and two empyemas in non-tumor. Lymphoma showed steep enhancement and others are slightly enhanced or not enhanced. Blood flow appearances on the cine images showed the blood circulation surrounding tumors and helped to understand the aneurysm sac and the rupture by aniosarcoma. 

 

IV. Conclusions: First pass DCE MRI could not distinguish all different cardiac tumors due to complicated enhancement patterns and few cases. Some malignant tumors have different enhancement patterns compared benign tumors. However, it can be useful to understand the enhancement patterns in highly vascular mass such as aneurysm, AVM, vascular hemangioma, and other vascular tumors.

 

 

Cardiac Tumor.pdf