PMC5181521_01
Cine MRI sequence of a 54-year-old male with eosinophilic granulomatosis. (A) 4-chamber view: focal lesion (arrow) involving the RV apex; (B) right 3-chamber view: lesion extending anteriorly just above the right ventricle outflow tract (RVOT). LA - left atrium; LV - left ventricle; RA - right atrium; RV - right ventricle.
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There was a focal lesion involving the RV apex (Figure 1A) extending anteriorly through just above the RV outflow tract (Figure 1B).
T2-weighted MRI sequence in a 54-year-old male with eosinophilic granulomatosis. Focal lesion filling the apex of the RV appearing as a heterogeneous signal ranging from iso- to hyper-intense (arrow). LA - left atrium; LV - left ventricle; RA - right atrium; RV - right ventricle.
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On T2-weighted and T2-weighted fat-suppression sequences, the mass noted to be iso- to hyper-intense (Figure 2).
First pass MRI gadolinium perfusion sequence in a 54-year-old male with eosinophilic granulomatosis. Red lines delimit the three layers with an inner layer showing no perfusional enhancement suggestive of mural-based thrombus (asterisk). Middle layer revealed mildly hyper-intense signal intensity and outer layers of normal RV myocardium wall (arrowheads) of iso-intense signal. LA - left atrium; LV - left ventricle; RA - right atrium; RV - right ventricle.
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The middle layer revealed mildly hyper-intense signal intensity and the outer layer of normal myocardium with iso-intense signal (Figure 3).
MRI Cine sequence of a 54-year-old male with eosinophilic granulomatosis showing involvement of the inferolateral wall beside the papillary muscle. (A) A hypertrophied papillary muscle (arrowhead) with subpapillary involvement (arrow). (B) Contrast-enhanced image 10 minutes after iv administration of 0.1 mmol/kg body weight of gadolinium: diffuse subendocardial delayed hyper-enhancement (arrow) with involvement of the papillary muscles (arrowhead). LA - left atrium; LV - left ventricle; RA - right atrium; RV - right ventricle.
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It also showed diffuse subendocardial delayed hyper-enhancement with involvement of the papillary muscles that were also seen in Cine sequences (Figure 4).