A 69 year old female asymptomatic who had a routine echocardiography which showed a left atrial mass. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with nromal systolic function. The overall LV ejection fraction is 64%, the LV end diastolic volume index is 74 ml/m2 (normal range: 65+/-11), the LVEDV is 126 ml (normal range 109+/-23), the LV end systolic volume index is 27 ml/m2 (normal range 18+/-5), the LVESV is 46 ml (normal range 31+/-10), the LV mass index is 37 g/m2 (normal range 67+/-11), and the LV mass is 63 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. A mass attached to the inter-atrial septum was noted with the following characteristics: short peduncle, some mobility, mildly heterogeneous, hyperintensive in T1 and T2 images, no fat component, same enhancement that suggest mild perfusion. The mass is not invading structures around it. The size is 22:15 mm. The anterior leaflet of the mitral valve contact the mass during systole. Based on location and statistic, the most common diagnosis is myxoma. Other tumors with perfusion cannot be ruled out. The T1 hyperintensity seen might be explained by a component of hemorrhage. Right VentricleThe right ventricle is normal in size . The overall RV ejection fraction is 55%, the RV end diastolic volume index is 73 ml/m2 (normal range 69+/-14), the RVEDV is 124 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 56 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size with normal systolic function. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is trace tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. The left ventricle is normal in size with nromal systolic function, the LVEF is 64%. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size , the RVEF is is 55%. 3. A mass attached to the inter-atrial septum was noted with the following characteristics: short peduncle, some mobility, mildly heterogeneous, hyperintensive in T1 and T2 images, no fat component, same enhancement that suggest mild perfusion. The mass is not invading structures around it. The size is 22 x 15 mm. The anterior leaflet of the mitral valve contact the mass during systole. Based on location and statistic, the most common diagnosis is myxoma. Other tumors with perfusion cannot be ruled out. The T1 hyperintensity seen might be explained by a component of hemorrhage. 4. The left atrium is normal in size. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.