Related Experiment Video
Updated: Oct 19, 2025
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Cardiovascular magnetic resonance imaging in suspected cardiac tumour: a multicentre outcomes study
Chetan Shenoy1, John D Grizzard2, Dipan J Shah3
1University of Minnesota Medical Center, Cardiovascular Division, Department of Medicine, 420 Delaware St MMC 508, Minneapolis, MN, USA.
Insights
Cardiovascular magnetic resonance (CMR) imaging accurately diagnoses cardiac tumors. CMR findings of no mass, pseudomass, or benign tumors indicate similar long-term survival, while malignant tumors and thrombi predict higher mortality.
Area of Science:
- Cardiology
- Medical Imaging
- Oncology
Background:
- Cardiovascular magnetic resonance (CMR) is crucial for diagnosing cardiac tumors, guiding patient management.
- Current management strategies rely on CMR diagnoses, but outcomes studies validating this approach are lacking.
Purpose of the Study:
- To assess the diagnostic accuracy and prognostic value of CMR in patients with suspected cardiac tumors.
- To validate the clinical management approach based on CMR diagnoses.
Main Methods:
- A multicenter study involving 903 patients undergoing clinical CMR for suspected cardiac tumors.
- CMR diagnoses included no mass, pseudomass, thrombus, benign tumor, or malignant tumor.
- All-cause mortality was the primary endpoint, with a median follow-up of 4.9 years.
Main Results:
- CMR demonstrated high diagnostic accuracy (98.4%).
- Patients with pseudomass and benign tumors had mortality rates similar to those with no mass.
- Malignant tumors (HR 3.31) and thrombi (HR 1.46) were associated with significantly greater mortality.
- CMR diagnosis provided prognostic value incremental to clinical factors (P < 0.001).
Conclusions:
- CMR imaging is highly accurate for diagnosing cardiac tumors.
- CMR diagnoses of no mass, pseudomass, and benign tumors correlate with similar long-term mortality.
- CMR diagnosis is a significant independent predictor of mortality, adding value beyond established clinical risk factors.
Aims:
Cardiovascular magnetic resonance (CMR) imaging is a key diagnostic tool for the evaluation of patients with suspected cardiac tumours. Patient management is guided by the CMR diagnosis, including no further testing if a mass is excluded or if only a pseudomass is found. However, there are no outcomes studies validating this approach.
Methods And Results:
In this multicentre study of patients undergoing clinical CMR for suspected cardiac tumour, CMR diagnoses were assigned as no mass, pseudomass, thrombus, benign tumour, or malignant tumour. A final diagnosis was determined after follow-up using all available data. The primary endpoint was all-cause mortality. Among 903 patients, the CMR diagnosis was no mass in 25%, pseudomass in 16%, thrombus in 16%, benign tumour in 17%, and malignant tumour in 23%. Over a median of 4.9 years, 376 patients died. Compared with the final diagnosis, the CMR diagnosis was accurate in 98.4% of patients. Patients with CMR diagnoses of pseudomass and benign tumour had similar mortality to those with no mass, whereas those with malignant tumour [hazard ratio (HR) 3.31 (2.40-4.57)] and thrombus [HR 1.46 (1.00-2.11)] had greater mortality. The CMR diagnosis provided incremental prognostic value over clinical factors including left ventricular ejection fraction, coronary artery disease, and history of extracardiac malignancy (P < 0.001).
Conclusion:
In patients with suspected cardiac tumour, CMR has high diagnostic accuracy. Patients with CMR diagnoses of no mass, pseudomass, and benign tumour have similar long-term mortality. The CMR diagnosis is a powerful independent predictor of mortality incremental to clinical risk factors.
More Related Videos
Related Concept Videos
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:28Imaging Studies for Cardiovascular System V: CT
01:24Magnetic Resonance Imaging
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...