Radiological Case: Left Ventricular Myocardial Hydatid Cyst

Shibani Mehra, DNB, DMRD; U.C. Garga, MD

Disclosures

Appl Radiol. 2018;47(6):36-38. 

In This Article

Imaging Findings

Transthoracic echocardiography revealed a cystic mass within the heart. Cardiac MR imaging (MRI) was performed with ECG gating to further characterize this mass. Bright blood cine SSFP gradient 4 chamber and short axis views revealed a large, well-marginated, round mass in the lateral wall myocardium of the left ventricle (Figure 1A) which demonstrated markedly hyperintense signal brighter than blood (Figure 1B). The mass had thin regular walls and was seen bulging into the LV cavity in the vicinity of the mitral valve. On double inversion recovery black blood T2-weighted MRI, homogeneous hyperintense fluid signal intensity in the mass indicated it to be a cyst and a surrounding thin hypointense rim was appreciated (Figure 2). There was no enhancement of the mass while the normal myocardium was seen enhancing on dynamic post-gadolinium inversion recovery MRI (Figure 3).

Figure 1.

(A) SSFP cine GRE Four-chamber image shows a well-marginated round hyper-intense mass with fluid signal intensity within the myocardium of left ventricle lateral wall. The mass is bulging into the cavity of left ventricle, suggestive of impending rupture. (B) Short-axis cine GRE bright blood image showing well-demarcated intramyocardial mass appearing brighter than blood

Figure 2.

T2-weighted four-chamber dark blood double inversion recovery MRI demonstrating well-demarcated mass surrounded by a thin hypointense rim located within the myocardium of LV wall.

Figure 3.

Dynamic post-gadolinium first-pass four-chamber MRI shows no enhancement of the intramyocardial mass.

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