Cardiac magnetic resonance in cardiac angiosarcoma-Which contrast-enhancement pattern is typical?

Intracardiac masses in a giant right atrium: Tumors or thrombus?

The coexist of primary angiosarcoma and thrombosis is a rare clinical entity. A 46-year-old male was presented with multiple right atrial (RA) masses. Two different vascular patterns in these masses were identified by contrast echocardiography. The possibility of coexistence of malignant tumors and thrombus in RA was implicated, which was further confirmed by computed tomography, magnetic resonance imaging, positron emission tomography/computer tomography, and pathologic examination. This case highlights the advantages of contrast echocardiography in the differential diagnosis of cardiac masses.

Clinical and Imaging Features of Primary Cardiac Angiosarcoma

This study aims to explore computed tomography (CT) and magnetic resonance imaging (MRI) features of patients diagnosed with primary cardiac angiosarcoma. The study involved the analysis of 12 patients diagnosed with primary cardiac angiosarcoma who underwent non-contrast (8/12) or contrast-enhanced CT (10/12) or MRI (4/12). Imaging appearances, including the tumor location and adjacent infiltration, were analyzed. All 12 lesions were located in the right atrium with a broad base. Adjacent invasion including the tricuspid valve and right ventricle (2/12), inferior or superior vena cava (2/12), pericardium (10/12), and right coronary artery (7/12) was common. On unenhanced CT scans, tumors in two patients were homogeneous in density, whereas the others were inhomogeneous. Ten patients showed heterogeneous enhancement. The enhancement pattern showed no direct correlation with the differentiation degree of the tumor. Four lesions manifested as heterogeneous intensity, with hyperintense hemorrhage foci on both T1- and T2-weighted MRI. Three showed rim enhancement and one showed patchy enhancement. Primary cardiac angiosarcoma often involves the right side of the heart with infiltration of peripheral structures. CT features include typical inhomogeneous density on unenhanced scans and heterogeneous centripetal enhancement on enhanced scans. A cauliflower-like appearance on both T1- and T2-weighted MRI is common. The characteristic enhancement pattern of MRI remains to be determined.