Visualization of Cardiac Myxoma Mobility With Real-Time Spiral Magnetic Resonance Imaging
A 75-year-old woman with atrial fibrillation and progressive heart failure had a transthoracic echocardiogram that showed an enlarged left atrium with a heterogeneous, echodense mass close to the septal base of the mitral valve. During diastole, this mass prolapsed through the mitral annulus into the left ventricle.
Severe dyspnea and arrhythmia nullified standard cardiac-triggered breath-hold cine MR imaging. Real-time spiral MRI allowed for ultrafast data acquisition during free breathing and without cardiac gating (100 ms/image). These images (Figure 1 and Movie) demonstrated the tumor mass, with diastolic prolapse through the mitral annulus. No respiratory or cardiac motion artifacts were seen due to real-time data acquisition.
During surgery, a large myxoma (Figure 2) of the left atrium originating from the atrial septum, close to the base of the mitral valve, was removed. .
Movie can be found Online Only at http://www.circulationaha.org
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.