The Assessment of Cardiac Masses by Cardiac CT and CMR Including Pre-op 3D Reconstruction and Planning

The purpose of this review is to (1) review the recent evidence examining the use of CT and CMR in the assessment of a suspected cardiac mass, (2) summarize the typical imaging features of the most common cardiac masses, and (3) examine the latest developments in the use of three-dimensional reconstructions and models in the preoperative assessment of a cardiac mass.

CMR can distinguish between tumors and non-tumor masses and between benign and malignant mass with a high degree of accuracy. CT and CMR are complementary tools in the evaluation of cardiac masses. CMR is the preferred initial imaging modality due to its versatile imaging planes and superior tissue characterization. CT better depicts calcification and has a higher spatial resolution compared with CMR, which is of particular importance in preoperative planning. CT also offers a valuable alternative in those with contraindications to CMR. Three-dimensional reconstructions, particularly of CT datasets, are a valuable adjunct in the preoperative assessment of a cardiac mass and may allow a better appreciation of the margins of the mass and its relationship with surrounding structures. Three-dimensional printing is an emerging technology which may be of additional value in selected patients with a cardiac mass.