Case from: Antonis Pantazis, Mark Westwood, The Heart Hospital, London, England
History: An 84 year old women presented breathless. Earlier in the year, she had undergone coronary artery bypass from which she had made a full recovery. Echocardiography demonstrated a left atrial mass, of uncertain aetiology.
Cine CMR, left, confirmed the large mass. Perfusion imaging, middle, at rest demonstrated no first pass perfusion within the mass. Early imaging, right (inversion recovery, long fixed TI of 480ms) confirmed avascularity.
Conclusion: Contrast MRI aids the diagnosis of thrombus and avascularity. Here, the mass is most likely thrombus, possibly related to a CVP line.
Ammendment 11/09/2007: the thrombus is in the left atrium so is very unlikely to be CVP line related - a peri-operative procoagulable state is a possible aetiology however. JMoon
