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Click 61 year old male with cardiac metastases of melanoma.
2 chamber view cine images.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
Steady-state free-precession (SSFP) gradient echo (GE) cine image before the administration of contrast agent.
TE 1.6 ms, TR 48.9 ms.

Significant findings: irregular, heterogeneous and thickened appearance of the myocardial wall with several nodular deposits in the myocardium, with variable penetration.


Click 61 year old male with cardiac metastases of melanoma.
3 chamber view cine images.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
Steady-state free-precession (SSFP) gradient echo (GE) cine image before the administration of contrast agent.
TE 1.71 ms, TR 51.3 ms.

Significant findings: irregular, heterogeneous and thickened appearance of the myocardial wall and several nodular deposits in the myocardium, with variable penetration. The biggest lesion infiltrates the interventricular septum.

Click 61 year old male with cardiac metastases of melanoma.
4 chamber view cine images.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
Steady-state free-precession (SSFP) gradient echo (GE) cine image before the administration of contrast agent.
TE 1.61 ms, TR 48.3 ms.

Significant findings: irregular, heterogeneous and thickened appearance of the myocardial wall and several nodular deposits everywhere in all the myocardium, with variable penetration: the biggest lesion has maximum diameters around 45x50 mm, infiltrates the interventricular septum and extends to the right cardiac apex. There is also an atrial polypoid mass in the right atrium (around 19x20 mm), near superior vena cava. The cardiac valves appeared normal.

Click 61 year old male with cardiac metastases of melanoma.
Short-axis view cine images.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
Steady-state free-precession (SSFP) gradient echo (GE) cine image before the administration of contrast agent.
TE 1.79 ms, TR 60.69 ms.

Significant findings: irregular, heterogeneous and thickened appearance of the myocardial wall and several nodular deposits everywhere in all the myocardium, with variable penetration: the biggest lesion infiltrates the interventricular septum and extends to the right cardiac apex.


Click 61 year old male with cardiac metastases of melanoma.
Transverse view cine images.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
Steady-state free-precession (SSFP) gradient echo (GE) cine image before the administration of contrast agent.
TE 1.79 ms, TR 60.69 ms.

Significant findings: irregular, heterogeneous and thickened appearance of the myocardial wall and several nodular deposits everywhere in all the myocardium, with variable penetration: the biggest lesion has maximum diameters around 45x50 mm, infiltrates the interventricular septum and extends to the right cardiac apex. There is also an atrial polypoid mass in the right atrium (around 19x20 mm) near superior vena cava. The cardiac valves appeared to be normal.


Click 61 year old male with cardiac metastases of melanoma.
T1 weighted turbo spin-echo short axis stacks before the administration of contrast agent.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
TE 7.1 ms, TR 671 ms.

Significant findings: several intramyocardial masses involving both ventricles, the biggest infiltrates the interventricular septum and extends to the right cardiac apex. The masses composition is heterogeneous, but most of them appear hyperintense on T1 weighted images.


Click 61 year old male with cardiac metastases of melanoma.
T1 weighted turbo spin-echo transverse stacks before the administration of contrast agent.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
TE 7.1 ms, TR 642 ms.

Significant findings: several intramyocardial masses involving both ventricles and the right atrium, the biggest lesion has maximum diameters around 45x50 mm, infiltrates the interventricular septum and extends to the right cardiac apex.
The composition of the masses is heterogeneous, but most of them are hyperintense on T1 weighted images.


Click 61 year old male with cardiac metastases of melanoma.
T2 weighted turbo spin-echo short axis stacks before the administration of contrast agent.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
TE 71 ms, TR 2135 ms.

Significant findings: several intramyocardial masses involving both ventricles, the biggest infiltrates the interventricular septum and extends to the right cardiac apex. The masses composition is heterogeneous, but most of them appear hyperintense on T2 weighted images.


Click 61 year old male with cardiac metastases of melanoma.
T2 weighted turbo spin-echo transverse stacks before the administration of contrast agent.
Cardiac magnetic resonance, 1.5 T MR System (Siemens, Symphony, Germany) with breath-holding technique.
TE 71 ms, TR 2033 ms.

Significant findings: several intramyocardial masses involving both ventricles and the right atrium, the biggest lesion has maximum diameters around 45x50 mm, infiltrates the interventricular septum and extends to the right cardiac apex.
The composition of the masses is heterogeneous, but most of them are hyperintense on T2 weighted images.


Click 61 year old male with cardiac metastases of melanoma.
Multiplanar reconstruction (MPR) of contrast enhanced CT of the chest in the arterial phase, without ECG-gating.
Somatom Definition 64-slice multidetector CT, Siemens, Germany.
Arterial phase after the intravenous injection of iodine contrast agent (100 ml at 5 ml/sec, Iomeron 400 mg iodine/ml, Bracco).
Slice thickness of 0,75 mm.
120 kVp, 160 mAs.

Significant findings.
MPR images confirmed the polymorphism of cardiac masses, both infiltrating and vegetating. The areas with the greater infiltration are the apex of the right ventricle, the mid-to-distal interventricular septum, the posterior wall of the right ventricle and the lateral wall of the left ventricle.


Click 61 year old male with cardiac metastases of melanoma.
Contrast enhanced CT of the chest in the arterial phase, without ECG-gating.
Somatom Definition 64-slice multidetector CT, Siemens, Germany.
Arterial phase after the intravenous injection of iodine contrast agent (100 ml at 5 ml/sec, Iomeron 400 mg iodine/ml, Bracco).
Slice thickness of 0.75 mm.
120 kVp, 160 mAs.

Significant findings: the neoplastic mass involves several cardiac walls, except of the left atrium; no evidence of calcification within the masses. the cardiac masses are both infiltrating and vegetating.
The polypoid mass in the right atrium shows maximum diameters of 30x34 mm.
The areas with the greater infiltration are the apex of the right ventricle, the mid-to-distal interventricular septum, the posterior wall of the right ventricle and the lateral wall of the left ventricle.
No evidence of pathological lymphadenopathy in the mediastinum, no pleural effusion, no pulmonary nodules. No filling defects in the pulmonary arteries.


Click 61 year old male with cardiac metastases of melanoma.
Contrast enhanced CT of the chest and the abdomen.
Somatom Definition 64-slice multidetector CT, Siemens, Germany.
Venous phase, 70 seconds after the intravenous injection of iodine contrast agent (100 ml at 5 ml/sec, Iomeron 400 mg iodine/ml, Bracco).
Slice thickness of 5 mm.
120 kVp, 98 mAs.

Significant findings.
We can notice in the liver a hypodense lesion of the III hepatic segment, with maximum diameters of 15x19 mm, the tumefaction of both adrenal glands (around 18x20 mm the left gland, 23x28 mm the right one), para-aortica and para-caval lymph nodes (11x13 mm and 13x15 mm); all these lesions are most likely metastases.


Click 61 year old male with cardiac metastases of melanoma.
Contrast enhanced CT of the brain, 300 seconds after the injection of iodine contrast agent (100 ml at 5 ml/sec, Iomeron 400 mg iodine/ml, Bracco).
Somatom Definition 64-slice multidetector CT, Siemens, Germany.
Slice thickness of 4 mm.
120 kVp, 98 mAs.

Significant findings.
Two lesions are clearly seen and highlighted by the contrast agent enhancement: the larger one is in the posterior parietal area and has maximum diameters of 25x32 mm, the second one is in the frontal lobe, in paramedian position and its measures are 15x18 mm. These lesions are most likely metastases.