Computed tomography of cardiac and pericardiac masses

Cardiac and paracardiac masses include benign and malignant tumors and nontumoral mass lesions. Metastatic tumors are far more common than primary cardiac tumors. Although echocardiography and magnetic resonance imaging (MRI) are the most frequently used imaging examinations, multidetector computed tomography (MDCT) is often used to evaluate these masses, particularly when MRI is contraindicated. MDCT is not only fast but also has high spatiotemporal resolution, multiplanar reconstruction capabilities, and a wide field of view, providing detailed evaluation of cardiac and paracardiac masses and adjacent structures, including the lungs. Knowledge of the characteristic and atypical imaging appearances is essential for thorough evaluation of these masses. In this pictorial review, the CT appearances of the most common cardiac and paracardiac masses are discussed and illustrated.