Malignant tumors of the heart and great vessels: MR imaging appearance.

Fortunately, primary tumors of the heart and great vessels are rare. These primary tumors include angiosarcoma, malignant fibrous histiocytoma, high-grade and pleomorphic sarcoma, and paraganglioma with pericardial and myocardial invasion. Symptoms are often nonspecific and include chest pain and dyspnea. Although these tumors are often diagnosed with echocardiography and computed tomography, magnetic resonance (MR) imaging currently appears to be the imaging modality of choice because of its diverse capabilities, which include multiplanar imaging for excellent anatomic definition of the heart, pericardium, mediastinum, and lungs; improved morphologic differentiation between tumor tissue and surrounding cardiovascular, mediastinal, or pulmonary tissues; dynamic imaging with a gated cine-loop acquisition; and assessment of tissue perfusion. The use of gadopentetate dimeglumine is helpful in achieving tumor enhancement on MR images but is not required. MR imaging is also useful in assessing tumor response to surgery, radiation therapy, and chemotherapy.