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Number 07-10: Tumor or Thrombus?

Case from: Dev Vaz and Jo Mahenthiran, Krannert Institute of cardiology, Indiana University, USA.

History: 61 year old male, known renal cell carcinoma with renal venous thrombosis.

Cine CMR: A large RV apical mass.

Tissue Characterisation: compared to myocardium:
Isointense on T1W TSE, 2
H yperintense on T2W TSE, 3
Heterogenous after contrast,4

The T2W pre contrast and heterogeneity post are not consistent with just thrombus. Subsequent biopsy confirmed the presence of metastatic high-grade renal cell carcinoma

Perspective: Cardiac MRI tissue characterization can be of great utility as an imaging tool to differentiate a thrombus from a malignant tumor

Scanner: Siemens Avanto

Reference: Sparrow PJ, et al. MRI of Cardiac Tumors. Radiographics. 2005; 25:1255-1276.

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