CT and MR imaging of benign primary cardiac neoplasms with echo cardiographic correlation

Benign primary cardiac neoplasms are rare but may cause significant morbidi ty and mortality. However, they are usually treatable and can often be diag nosed with echocardiography, computed tomography (CT), or magnetic resonanc e (MR) imaging. Myxomas typically arise from the interatrial septum from a narrow base of attachment. Fibroelastomas are easily detected at echocardio graphy as small, mobile masses attached to valves by a short pedicle. Cardi ac fibromas manifest as a large, noncontractile, solid mass in a ventricula r wall at echocardiography and as a homogeneous mass with soft-tissue atten uation at CT. They are usually homogeneous and hypointense on T2-weighted M R images and isointense relative to muscle on T1-weighted images. Paragangl iomas usually appear as large, echogenic left atrial masses at echocardiogr aphy and as circumscribed, heterogeneous masses with low attenuation at CT. These tumors are usually markedly hyperintense on T2-weighted MR images an d iso- or hypointense relative to myocardium on T1-weighted images. Cardiac lipomas manifest at CT as homogeneous, low-attenuation masses in a cardiac chamber or in the pericardial space and demonstrate homogeneous increased signal intensity that decreases with fat-saturated sequences at TI-weighted MR imaging. Cardiac lymphangiomas manifest as cystic masses at echocardiog raphy and typically demonstrate increased signal intensity at T1- and T2-we ighted MR imaging. Familiarity with these imaging features and with the rel ative effectiveness of these modalities is essential for prompt diagnosis a nd effective treatment.