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Number 08-09 Lipomatous Hypertrophy of the Interatrial Septum (LHIAS)

Case from: Vincent Sorrell, Maria Altbach, Eliza Panczyk, Robert Attaran, Imran Ata, Ali Bilgin, Mohammed Habibzadeh.
Departments of Cardiology, Radiology, and Electrical and Computer Engineering, University of Arizona and the Sarver Heart Center, Tucson AZ, USA.

History: 73 year male. 1 year hx of myalgia and weight loss. RA mass on echo.

CMR Cine: A large mass with classic bi-lobed (“dumbbell”) appearance involving the atrial septum and sparing the fossa ovalis was detected on a steady-state free precession imaging sequence (figure 1).

Advanced CMR: Axial cuts through the mass were acquired using a novel IDEAL-GRASE technique where pure lipid (figure 2a) and water (figure 2b) images are generated from data acquired in a single breath hold. The mass (arrow) has high signal intensity in the lipid image but none in the water image.

CMR processing: A color-coded lipid-over-water overlay image was then generated for three axial slices (figures 3a-c) and percentage lipid signal maps were also obtained (figure 3d-f) using the data from the IDEAL-GRASE acquisition.

Perspective: CMR is an excellent non-invasive method to diagnose and differentiate benign LHIAS from other cardiac masses. The IDEAL-GRASE method allows visualisation and quantification of lipid content from data acquired in a single breath hold.

Scanner: 1.5T GE Signa NV-CV with 14X platform and advanced
cardiac software (GE research package); 8 channel cardiac coil.
References: [1] Tatli et al AJR 2004;182:598-600
[2] Li et al Magn Reson Med 2007; 57:1047-1057

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