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(BQ) Part 2 book “Carsiac imaging – A core review” has contents: Cardiac masses, valvular disease, pericardial disease, congenital heart disease, acquired disease of the thoracic aorta and great vessels, devices and postoperative appearance. | 6 Cardiac Masses QUESTIONS 1a The abnormality is in A. The left atrium B. The left ventricle C. The right atrium D. The right ventricular outflow tract (RVOT) E. The aorta Answer 1a Answer B. Coronal postcontrast image shows a mass along the inferior apical left ventricular cavity. Left atrium is not shown in this image. Right atrium appears grossly normal. RVOT is not fully seen but appears normal. Visualized ascending aorta appears normal. 1b What is the best treatment for this lesion? A. Surgical resection B. Chemotherapy C. No treatment D. Anticoagulation Answer 1b Answer D. Left ventricular thrombus is most often associated with postinfarct wall motion abnormalities. Note the enhancement along the infarcted myocardium while there is no enhancement of the mass. Treatment of choice is anticoagulation. This is not a mass that requires surgical resection or chemotherapy. Treatment is necessary to prevent complications of thrombus embolization. P.98 1c What is the most common type of mass seen in the heart? A. Myxoma B. Angiosarcoma C. Thrombus D. Rhabdomyoma E. Melanoma Answer 1c Answer C. The most common mass in the heart is thrombus. The most common benign cardiac tumor is myxoma. The most common malignant tumor is angiosarcoma. The most common tumor in children is rhabdomyoma. Melanoma can metastasize to the heart but is not the most common cause of cardiac mass. References: Grebenc ML, Rosado de Christenson ML, Burke AP, et al. Primary cardiac and pericardial neoplasms: radiologic-pathologic correlation. Radiographics 2000;20(4):1073-1103; quiz 1110-1111, 1112. Review. PubMed PMID: 10903697. Sparrow PJ, Kurian JB, Jones TR, et al. MR imaging of cardiac tumors. Radiographics 2005;25(5):1255-1276. Review. PubMed PMID: 16160110. 2a Where is the abnormality? A. Aorta B. Pulmonary artery C. Pulmonary vein D. Left atrium E. Left atrial appendage Answer 2a Answer E. Postcontrast gated coronary CTA shows a low-attenuation filling defect at the tip of the left .
