Tumors of the cardiac valves: imaging findings in magnetic resonance imaging, electron beam computed tomography, and echocardiography

We describe the findings from various cross-sectional imaging modalities in patients with cardiac valve adherent masses. The techniques are discussed, and imaging findings are compared with the results of cardiac surgery. All three patients had neurological symptoms and/or cardiac murmurs. Transthor acic and/or transesophageal echocardiography revealed the cardiac mass in a ll three. For differentiation of thrombus and cardiac neoplasm magnetic res onance imaging (MRI) was also performed in all three patients and electron- beam computed tomography (EBCT) in two. Fast segmented cine gradient ent-ec ho MRI techniques provided mass depiction in;all patients, while T1-weighte d spin-echo imaging failed in mass detection in one patient. None of the pa tients showed evidence of valve regurgitation or stenosis in flow sensitive cine MRI. EBCT excluded mass calcifications in both patients and reliably demonstrated the valve attached lesions. Although echocardiography is the m odality of choice in evaluating cardiac masses and especially valve attache d masses, MRI and EBCT provide additional information about tissue characte ristics and allows an excellent overview of the cardiac and paracardiac mor phology. Fast segmented cine gradient-echo MRI is especially able to depict even small tumors attached to rapidly moving cardiac valves, and valve com petence can be easily assessed within the same examination.