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Number 08-11 CMR for RA Mass characterization

Case from: Ali Z. Merchant, John Hibbeln and Clifford J Kavinsky. Rush University Medical Center, Chicago, IL, USA.

History: A 37 yr female had an echocardiogram for chest pain showing a possible mass in the right atrium. CMR was performed to further characterise this.

CMR: A well circumscribed, ovoid mass (3x3x2cm) in the right atrium along the free wall. This area appears hyper-intense on images obtained using T1 weighted turbo SE sequence. However, there is signal suppression in this area, as well as abdominal adipose tissue, when fat saturation sequences are applied. These findings are higly suggestive of a lipoma. No invasion of the atrial wall is noted.

Perspective: Cardiac MR offers excellent differentiation of suspected cardiac masses via tissue characterisation as well as their relationship to adjacent structures. A cardiac lipoma can be easily identified due to its typical T1 relaxation time and signal suppression with fat saturated sequences. There has been no further treatment of this incidental finding given that there is no arrhythmia or hemodynamic compromise.

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