Visualization of cardiac myxoma mobility with real-time spiral magnetic resonance imaging.

A75-year-old woman with atrial fibrillation and progressive heart failure had a transthoracic echocardiogram that showed an enlarged left atrium with a heterogeneous, echodense mass close to the septal base of the mitral valve. During diastole, this mass prolapsed through the mitral annulus into the left ventricle. Severe dyspnea and arrhythmia nullified standard cardiactriggered breath-hold cine MR imaging. Real-time spiral MRI allowed for ultrafast data acquisition during free breathing and without cardiac gating (100 ms/image). These images (Figure 1 and Movie) demonstrated the tumor mass, with diastolic prolapse through the mitral annulus. No respiratory or cardiac motion artifacts were seen due to real-time data acquisition. During surgery, a large myxoma (Figure 2) of the left atrium originating from the atrial septum, close to the base of the mitral valve, was removed.