[Gadolinium-DTPA magnetic resonance imaging in the diagnosis of left atrial myxoma in the elderly].

A 85-year-old woman consulted our hospital with general fatigue, palpitation and chest discomfort changing with different postures. Her electrocardiogram showed sinus tachycardia, atrial premature beats and left atrial overload. 53% cardiothoracic ratio, slightly protruding third arch of the cardiac silhouette and dilated pulmonary artery were seen on the chest X-ray. Two dimensional echocardiography revealed a mass in the left atrium although the quality of echocardiography was suboptimal due to her thoracic deformity. There was no uptake of T1-201 or Ga-67 by the mass. The four-chamber view of Tc-99m ECG-gated SPECT radionuclide angiocardiography showed a filling defect in the left atrium. The T1 weighted magnetic resonance imaging revealed a left atrial mass with relatively low signal intensity. After intravenous injection of Gadolinium-DTPA the signal intensity of the mass increased significantly and the contrast of the mass was improved. The size of the mass was 4 x 4 x 3 cm with a stalk connecting to the interatrial septum. These findings were compatible with left atrial myxoma. Gadolinium-DTPA magnetic resonance imaging is useful in diagnosing left atrial myxoma because it provides information on the size, anatomical location, relationship with other cardiovascular structures and even the characteristics of the mass.