Question:

Which of the following are normally occurring structures which could mimic tumours in the heart?
1. Coumadin ridge
2. Eustachian valve
3. Prominent crista terminalis
4. Left atrial myxoma
5. Lipomatous hypertrophy of the inter-atrial septum





Answer:

The correct answers for the question "Which of the following are normally occurring structures which could mimic tumours in the heart?" are:

1. Coumadin ridge

2. Eustachian valve

3. Prominent crista terminalis

5. Lipomatous hypertrophy of the inter-atrial septum



Explanation

Normally occurring embryological remnants can mimic tumours on cardiac magnetic resonance imaging. These so called pseudotumours include the eustachian valve, a prominent crista terminalis as well as lipomatous hypertrophy of the inter-atrial septum. The coumadin ridge is also a normally occurring structure which can present as a linear structure or even sometimes as a nodular mass that protrudes into the left atrium. A left atrial myxoma is an abnormal, usually benign tumour which usually requires surgical evaluation.



From the manuscript:
The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging
Radiology Case. 2009 Sep; 3(9):1-5


This article belongs to the Cardiac section.




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From the manuscript

The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging

Free full text article: The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging

Abstract
A coumadin ridge is an occasionally observed, but seldom described structure seen in the left atrium during cardiac magnetic resonance (CMR) imaging. In this case, the coumadin ridge was particularly prominent and could easily have been mistaken for a tumour or thrombus. Using the combined assessment from different CMR pulse sequences, we were able to correctly identify it as the coumadin ridge. We make the reader aware of the location and the CMR imaging features of this structure so that misdiagnosis may be avoided.






References



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5. Weinsaft JW, Kim HW, Shah DJ. Detection of left ventricular thrombus by delayed-enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction. J Am
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6. Fieno DS, Saouaf R, Thomson LEJ. Cardiovascular magnetic resonance of primary tumors of the heart: A review. J Cardiovasc Magn Reson 2006;8(6):839-853.
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7. Hoffmann U, Globits S, Frank H. Cardiac and paracardiac masses. Current opinion on diagnostic evaluation by magnetic resonance imaging Eur
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