3D-VIBE序列对血管压迫性三叉神经痛和面肌痉挛诊断价值

目的探讨3.0 T磁共振3D扰相梯度回波(3D-VIBE)序列对于三叉神经痛和面肌痉挛责任血管的诊断价值。方法利用3D-VIBE的原始图像重建,从不同的角度观察神经与血管的走行关系,发现责任血管,并与临床微血管减压术(MVD)进行比对。结果进行3D-VIBE序列扫描后发现责任血管,与术中所见基本符合。血管呈高信号,神经呈等信号,对比良好,能够直观显示血管与神经的解剖结构。三叉神经痛的症状侧的血管压迫阳性符合率为90.6%(29/32),面肌痉挛的症状侧的血管压迫阳性符合率为89.4%(17/19)。结论 3D-VIBE序列对于发现血管压迫性三叉神经痛和面肌痉挛责任血管,明确血管与神经的关系有诊断价值。     

MRI在三叉神经痛和半侧面肌痉挛病因诊断中的价值

目的 探讨MRI在诊断三叉神经痛与半侧面肌痉挛中的价值.方法 将51例三叉神经痛与23例半侧面肌痉挛患者的术前MRI资料与手术结果进行对照分析.结果 ①74例患者中,MRI诊断患侧桥小脑角胆脂瘤8例,听神经瘤7例,三叉神经瘤4例,脑膜瘤3例,患侧神经微血管压迫49例(66.21％),MRI未见异常者3例(4.05％);②手术病理结果:胆脂瘤8例,听神经瘤7例,三叉神经瘤4例,脑膜瘤3例,三叉神经或面神经根部异常血管压迫者46例(62.16％),术中未见异常者6例(8.11％).结论 MRI在三叉神经痛和半侧面肌痉挛病因诊断中具有很高价值,是术前首选的检查方法.     

面肌抽搐与三叉神经痛的MRI诊断

目的　探讨面肌抽搐及三叉神经痛患者血管压迫病因的MR表现及其诊断价值。方法　回顾性分析了 12 0例面肌抽搐及三叉神经痛患者MR表现及手术结果。结果　 (1) 6 3例面肌抽搐患者MR显示 12 6侧面听神经共发现 5 8侧存在神经血管压迫或接触 ,17侧可疑接触 ;5 7例三叉神经痛患者MR显示 114侧三叉神经共发现 4 5侧存在神经血管压迫或接触 ,12侧可疑接触。 (2 )统计学分析结果 :面肌抽搐患者症状侧和无症状侧差异有非常显著性意义 (χ2 =31 6 6 ,P <0 0 0 1) ;三叉神经痛患者症状侧和无症状侧差异有非常显著性意义 (χ2 =4 2 98,P <0 0 0 1)。 (3)根据手术结果 ,MR诊断面肌抽搐及三叉神经痛患者神经血管压迫或接触的敏感度为 94 % ,准确度为 83% ,阳性似然比为1 88。结论　MRI能清晰显示三叉神经脑池段与毗邻血管之间的关系 ,对面听神经及三叉神经血管压迫或接触的正确诊断具有较高的敏感度和准确度 ,为临床医师提供术前评估和指导治疗有极其重要的意义。     

Three-dimensional MRI of hemifacial spasm with surgical correlation

MRI was used to investigate 100 patients with hemifacial spasm, using 3D-FT T2-weighted (CISS) and contrast-enhanced 3D-FT T1-weighted (turbo-FLASH) sequences in all cases. MR angiography was performed in 54 patients, using 3D-MT FISP images. Decompression of the facial nerve through a retromastoid craniotomy was performed in all patients. Hemifacial spasm caused by tumours in the cerebellopontine angle was not included. Vascular contact with the facial nerve root-exit zone or at the internal auditory canal was present in 96 of 100 patients with hemifacial spasm. The vessel responsible was the vertebral artery (VA) in 18 cases, the posterior inferior cerebellar artery (PICA) in 23, the anterior inferior cerebellar artery (AICA) in 22, the VA and PICA in 24, VA and AICA in 3, PICA and AICA in 1, VA, PICA and AICA in 4, and a vein in 1 case. CISS images showed compressive vascular loops better than contrast-enhanced turbo-FLASH images alone. The sensitivity of MRI was high, since only one false-negative case was found among the 100 patients who underwent surgery. Received: 10 July 1995 Accepted: 4 June 1996     

CT在三叉神经痛和半侧面肌痉挛诊断中的应用价值

目的:探讨CT在诊断三叉神经痛与半侧面肌痉挛中的价值。方法:将772例经手术治疗的三叉神经痛(326例)与半侧面肌痉挛(446例)患者的术前CT资料与手术结果进行对照分析。结果:①CT表现:772例患者中,CT发现患侧桥小脑角胆脂瘤26例,听神经瘤14例,三叉神经瘤8例,脑膜瘤6例,患侧桥小脑角扩张增粗血管490例(63.47%),CT未见异常者228例(29.6%);②手术病理结果:胆脂瘤27例,听神经瘤14例,三叉神经瘤8例,脑膜瘤6例,三叉神经或面神经根部异常血管压迫者696例(90.15%),术中未见异常者21例。结论:CT在病因诊断方面很有帮助,它既可以发现桥小脑角占位病变,又能显示桥小脑角扩张增粗的血管,是术前有效的检查方法。     

血管压迫性三叉神经痛责任血管的3.0T MRI研究

目的 采用3.0 T MRI显示三叉神经及周围血管的解剖关系,分析产生原发性三叉神经痛(TN)的血管压迫特点.方法 选择50例TN患者(50支TN患侧和50支TN对侧三叉神经;其中23例行微血管解压术)和50名没有面部疼痛的志愿者(100支非TN三叉神经),在3.0TMR采用三维快速稳态梯度回波序列(3D TRU-FISP)及3D 三维时间飞跃(TOF-MRA)扫描.若判断TN患者为静脉病变,并行增强3D快速小角度反转序列(3DFLASH)扫描.以上图像融合重建成虚拟脑池图,评价神经血管压迫程度分级(1级无压迫,2级静脉性压迫,3级神经与动脉接触,4级有动脉压痕,5级动脉压迫导致神经明显移位),以及血管接触神经的方位(三叉神经的上侧或其他侧)、血管神经接触点的位置(近:位于三叉神经脑池段近脑干1/3长度区域,远:位于三叉神经脑池段远脑干2/3长度区域).3D TRU-FISP序列重建的冠、矢状面图像用于测量神经长度、神经横截面及脑池面积.采用卡方检验观察2组的三叉神经:血管压迫神经引起神经切迹或移位(4级和5级)、血管神经压迫点和神经出脑干处距离、血管压迫神经的位置位于神经上侧方的发生率.采用t检验观察测量数值的统计学意义,并用Logisac回归分析三叉神经痛的发病因素.结果 两序列及融合图像可以清晰显示神经血管的关系,与23例微血管解压术中所见吻合度高,术后症状消失或明显减轻21例.血管压迫或接触三叉神经的发生率在志愿者组(1级79支,2级5支,3级8支,4级8支)、TN对侧(1级27支,2级6支,3级9支,4级8支)及TN患侧(1级4支,2级t2支,3级12支,4级7支,5级15支)分别为21.0％(21/100)、46.0％ (23/50)、92.0％ (46/50).TN患侧三叉神经较志愿者三叉神经血管受压迫程度4、5级者差异有统计学意义(x2=27.0,P ＜0.01);血管接触点的位置在TN患侧近32支、远14支,在志愿者近4支、远17支(x2=14.8,p＜0.01);压迫血管位置中,TN患侧位于神经上侧36支、其他侧10支,志愿者中位于神经上侧5支、其他侧16支(x2=18.0,P＜0.01);所在层面脑桥池面积,TN患侧为(183.9+52.5) mm2、对侧为(217.8±58.8)mm2(t=-3.04,P＜0.01);脑池段神经中点截面积,TN患侧为(6.3±1.3)mm2、对侧为(7.7±1.6) mm2(t=-4.8,P＜0.01);脑池段神经长度,TN患侧为(8.0±1.9)mm、对侧为(9.0±2.0)mm(t=-2.64,P＜0.05),差异均有统计学意义.结论 MR可以清楚显示TN患者血管与三叉神经的关系,受压迫神经位置更靠神经近端及头侧、神经所在层面脑桥池面积较小者,均是较强的手术指征.     

Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia

The published rates of operatively confirmed neurovascular compression as the cause for trigeminal neuralgia range from 10 % to nearly 100 %. High-definition magnetic resonance angiography (MRA) was performed in 27 consecutive patients (in 6 cases with 3D reconstructions) to show neurovascular compression preoperatively. The MRA findings were compared with the relationship between the Vth nerve and the surrounding vessels at surgery. In 23 patients MRA showed present neurovascular compression in accordance with surgical findings (18/27 in complete accordance of type and side of vessel, site and direction of compression). One woman had no neurovascular compression either on MRA or intraoperatively. One MRA prediction of neurovascular compression was false, and two results were false negative. The sensitivity of MRA was therefore 88.5 % but the specificity only 50 %, if surgical findings are the reference. In one patient with right trigeminal neuralgia MRA revealed bilateral neurovascular compression of the Vth nerves. Therefore, the overall specificity of MRA might be below 50 %. In one patient with multiple sclerosis, the decision to operate was markedly influenced by the clear finding of neurovascular compression on MRA. The patient has been free from trigeminal pain for 149 weeks after microvascular decompression. In 6 patients, 3D reconstructions of the MRA data were performed. The images helped in 3D visualisation of the operation, but did not yield new information about the nature of the vessels revealed, or the site, direction or side of the neurovascular compression. Received: 15 May 1997 Accepted: 18 June 1997     

三叉神经痛、面肌痉挛的影像学表现与手术结果对照研究(附315例报告)

目的:分析总结三叉神经痛和面肌痉挛的影像学表现,经与手术结果对照,探讨三叉神经痛和面肌痉挛的主要致病原因。方法:回顾性分析2001年～2006年我院收治的315例三叉神经痛和面肌痉挛患者的有关资料。结果:术前CT平扫67例,15例显示椎基底动脉迂曲、增粗、偏移,占22.4%。248例均做桥小脑角区MRI,显示血管神经接触或可疑接触者188例,占75.8%。手术病例296例,术中证实有血管压迫或接触的271例,占91.6%;肿瘤压迫所致20例,占6.8%;有蛛网膜粘连和其它原因不明者5例,占1.7%,19例为保守治疗。结论:MRI诊断三叉神经痛和面肌痉挛的病因与手术结果对照最接近,则主要为周围血管压迫神经所致。     

面肌痉挛的3.0T3D-TOF MRA表现分析及病因诊断

目的 探讨面肌痉挛的3.0T 3D-TOF-MRA表现及病因诊断.方法 回顾性分析48例面肌痉挛患者术前3D-TOF-MRA图像,观察血管与面神经的毗邻关系,判明责任血管,并与术中所见血管与面神经的毗邻关系进行对照分析.结果 48例患者术中均找到责任血管:术前3D-TOF-MRA判明责任血管46例(95.8％),与术中所见相一致;2例(4.2％)责任血管来源不明;面神经受压位置在神经根出脑干处(REZ)44例(91.7％),在面神经中1/3段1例(2％),在外1/3段3例(6.3％);患侧与健侧均有血管压迫者31例,邻近血管的粗细和血管是否成袢是引起面肌痉挛的主要因素,对是否产生症状具有统计学意义(P ＜0.05).结论 MRA发现有血管与面神经毗邻未必一定产生面肌痉挛的症状,只有将MRA所见责任血管与面神经的毗邻关系同临床症状相结合,才能对显微外科血管解压术(MVD)的成功实施提供重要的指导意义.     

磁共振3D-TSE序列和3D-VIBE序列在诊断血管压迫性三叉神经痛中的价值

目的探讨磁共振3 D-TSE序列和3 D-VIBE序列对于血管压迫性三叉神经痛的诊断价值。方法采用3 DTSE序列和3 D-VIBE序列扫描28例临床拟诊为血管压迫性三叉神经痛的患者。经3 DMRP、MIP、min-MIP后处理图像,观察三叉神经与周围血管的关系。结果 28例患者手术证实26例存在血管神经接触或压迫,3 D-VIBE、3 D-TSE序列综合判断血管压迫性三叉神经痛的阳性预测值、阴性预测值、敏感性、手术符合率分别为92.0%(23/25)、33.3%(1/3)、92.0%(23/25)、85.7%(24/28)。而且MRI所显示的责任血管与神经的相对位置关系与术中所见具有高度的一致性(K=0.81)。结论 3 D-TSE序列和3 D-VIBE序列结合可以清楚显示脑池内血管和三叉神经的空间关系并辨认责任血管的来源,对血管压迫性三叉神经痛的术前评估具有较高的价值。     

高场MRI斜矢状位与斜冠状位扫描在贲门癌术前检查中的应用价值

目的:探讨改进高场MRI斜矢状位与斜冠状位扫描在贲门癌术前检查中的应用价值.方法:回顾性分析69例贲门癌患者的MR I图像资料,MR I检查均采取平行于食管下段长轴的斜矢状位、斜冠状位和标准正矢状位、正冠状位的扫描方法.两位MR I诊断医师采用双盲法根据食管MR I图像评判两种不同扫描方法下距离肿块边缘的食管胸下段及腹...     

Patterns of neurovascular compression in patients with classic trigeminal neuralgia: A high-resolution MRI-based study

Purpose

To describe the anatomical characteristics and patterns of neurovascular compression in patients suffering classic trigeminal neuralgia (CTN), using high-resolution magnetic resonance imaging (MRI).

Materials and methods

The analysis of the anatomy of the trigeminal nerve, brain stem and the vascular structures related to this nerve was made in 100 consecutive patients treated with a Gamma Knife radiosurgery for CTN between December 1999 and September 2004. MRI studies (T1, T1 enhanced and T2-SPIR) with axial, coronal and sagital simultaneous visualization were dynamically assessed using the software GammaPlan™. Three-dimensional reconstructions were also developed in some representative cases.

Results

In 93 patients (93%), there were one or several vascular structures in contact, either, with the trigeminal nerve, or close to its origin in the pons. The superior cerebellar artery was involved in 71 cases (76%). Other vessels identified were the antero-inferior cerebellar artery, the basilar artery, the vertebral artery, and some venous structures. Vascular compression was found anywhere along the trigeminal nerve. The mean distance between the nerve compression and the origin of the nerve in the brainstem was 3.76 ± 2.9 mm (range 0–9.8 mm). In 39 patients (42%), the vascular compression was located proximally and in 42 (45%) the compression was located distally. Nerve dislocation or distortion by the vessel was observed in 30 cases (32%).

Conclusions

The findings of this study are similar to those reported in surgical and autopsy series. This non-invasive MRI-based approach could be useful for diagnostic and therapeutic decisions in CTN, and it could help to understand its pathogenesis.     

三叉神经痛MRI序列研究及诊断价值

目的 探讨MR序列对导致三叉神经痛病变的显示能力及诊断价值.方法 回顾性分析60例三叉神经痛患者临床及MRI资料,与临床手术对照,比较不同序列MRI显示病变能力.所有患者均行常规头部MR平扫,其中9例行增强扫描,49例行桥小脑角区高分辨3D-TOF和3D-快速SE(TSE)序列扫描.利用x2检验分析3D-TOF和3D-TSE两序列的敏感度、特异度和准确度.结果 MR常规平扫及增强扫描显示6例桥小脑区肿瘤、3例三叉神经根及其周围脑膜炎,以及脑干多发硬化斑块及梗死各1例.49例为神经血管压迫所致,与手术对照3D-TOF和3D-TSE序列显示血管压迫的敏感度、特异度、准确度分别为95.3％ (41/43)、66.7％ (4/6)、91.8％ (45/49)和95.6％ (43/45)、50.0％ (2/4)、91.8％ (45/49),两者差异无统计学意义(x2值分别为0.13、0.19、0.17,P值均＞0.5).结论MRI对显示和诊断三叉神经痛病因具有重要意义.MR全脑常规扫描可以显示或排除肿瘤、炎症等病变.桥小脑角区3D-TOF和3D-TSE扫描可以敏感和准确地显示和明确神经、血管的关系.     

Extraspinal dural arteriovenous fistula in a patient with lipomyelodysplasia: value of MRI and MRA

Spinal dural arteriovenous fistulae are extremely rare in spinal dysraphism. A fistulous malformation within a lipomyelomeningocele has not been reported previously. A 50-year-old man presented with progressive paraparesis and bladder dysfunction. MRI revealed a large lumbar lipomyelomeningocele. A vascular malformation was indicated by abnormal signal in the thoracolumbar spinal cord and dilated perimedullary veins. Phase-contrast MRA demonstrated only the slow-flow veins of the fistula and an intradural ascending vein. Contrast-enhanced ultra-fast MRA gave excellent delineation of all parts of the fistula within the dysraphic lesion. Received: 5 November 1998 Accepted: 30 January 1999     

Improving postoperative MR imaging of pituitary macroadenomas: comparison of full and reduced dose of gadopentetate dimeglumine

The aim of this study was to evaluate the efficacy of contrast-medium (CM)-enhanced MR imaging of operated pituitary macroadenomas with reduced dose of gadopentetate dimeglumine. In a prospective study 18 patients were examined with coronal T1-weighted MR imaging prior to and following intravenous CM injections. Two sets of contrast-enhanced coronal images were obtained in each patient; the first set after 50 % of the recommended dose of 0.1 mmol/kg body weight (b. w.) had been administered, and the second set immediately after additional CM had been given to make up a total dose of 0.1 mmol/kg b. w. The images were evaluated by three neuroradiologists. The SIPAP classification system was used to evaluate tumour extension, whereas tumour margin conspicuity was scored using an arbitrary scale of 1–5 (1 = indistinct, 5 = well defined). Signal intensity measurements obtained from the most enhancing part of the adenomas demonstrated increased enhancement with increased CM dose. Tumour delineation scores were significantly better on the reduced- and full-dose images than on pre-CM injection images, but, with one exception, tumour extension was identified as the same on all imaging sequences. Postoperative MR imaging of large macroadenoma residues can routinely be performed without intravenous CM. When CM is indicated a reduced dose of gadopentetate dimeglumine should provide sufficient diagnostic information. Received: 29 June 1999; Revised: 2 December 1999; Accepted: 14 March 2000     

Fast FLAIR sequence for detecting major vascular abnormalities during the hyperacute phase of stroke: a comparison with MR angiography

In the hyperacute phase of stroke, occluded vessels can be seen as high signal on fast-FLAIR images or as absence of flow-related enhancement in maximum-intensity projection (MIP) MR angiography (MRA). To compare these techniques, we examined 53 patients within 6 h of a stroke, using a standardised MRI protocol including fast-FLAIR and 3D time-of-flight TOF MR to detect vessel occlusion or reduced flow corresponding to the suspected ischaemic territory. Brain infarcts were confirmed on MRI after 1–5 days in 41 cases (77 %). The overall accuracy of 3D-TOF MRA was 68 % and sensitivity, specificity, positive and negative predictive values were 67 %, 71 %, 87 %, and 43 % respectively. Values for the fast-FLAIR sequence were: 65 %, 85 %, 93 % and 44 %, with an overall accuracy of 70 %. The fast-FLAIR sequence was thus able to show occluded vessels or reduced flow with about the same accuracy as 3D-TOF MRA and enabled better prediction of the ischaemic area. Received: 25 June 1998 Accepted: 3 September 1998     

Follow-up of patients with previous treatment for coarctation of the thoracic aorta: comparison between contrast-enhanced MR angiography and fast spin-echo MR imaging

Regular follow-up is required in patients with previous intervention for coarctation of the aorta to detect recoarctation or aneurysm formation. In this study we describe the findings encountered on routine follow-up exams and we compare the use of contrast-enhanced 3D MR angiography (CE MRA) with fast spin-echo MRI (FSE) to study the thoracic aorta after previous intervention. In 51 consecutive patients previously treated for aortic coarctation, 74 MR studies of the thoracic aorta were performed during a 2-year period using CE MRA and FSE MRI. The thoracic aorta was evaluated for abnormalities of course, caliber, shape, and pathology of side branches. The CE MRA and FSE MRI studies were evaluated side by side by consensus of two reviewers evaluating which MR technique depicted the abnormalities of the thoracic aorta the best. Of 74 exams, six clinically important abnormalities were found: four aneurysms and two restenoses. Two small pseudoaneurysms were missed on the FSE studies. Contrast-enhanced MRA was judged to visualize aortic abnormalities better than FSE (47 of 74 MR studies) especially for the transverse aortic arch, coarctation site, left subclavian artery, and aortic arch configuration. For the ascending aorta and distal descending aorta, CE MRA and FSE performed equally well. Aortic diameters measured at four levels in the first 18 MRI studies showed no significant differences in diameter when measured by FSE or CE MRA (p = not significant). Clinically important abnormalities, such as aneurysm formation and restenosis, can be present years after treatment for aortic coarctation. In the regular follow-up of these patients, CE MRA may provide additional diagnostic information compared with FSE and should be included as part of the routine exam. Received: 3 April 2000; Revised: 5 July 2000; Accepted: 7 July 2000     

MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis

The aim of the study was to evaluate the additional findings of MRI following small bowel enteroclysis and to compare the efficacy of negative and positive intraluminal contrast agents. Fifty patients with inflammatory or tumorous small bowel disease were investigated by small bowel enteroclysis and consecutive MRI using breathhold protocol (T1-weighted fast low-angle shot, T2-weighted turbo spin echo). Patients were randomly assigned to either receiving a positive oral (Magnevist, Schering, Berlin, Germany) or a negative oral MR contrast media (Abdoscan, Nycomed, Oslo, Norway). The pattern of contrast distribution, the contrast effect, presence of artifacts, as well as bowel wall and extraluminal changes, were determined and compared between the contrast type using Fischer's exact test. Sensitivity, specificity, and diagnostic accuracy for MRI and enteroclysis were calculated. Twenty-seven patients had clinically proven Crohn's disease and two patients surgically proven small bowel tumours. Magnetic resonance imaging had important additional findings as abscesses and fistulae in 20 patients. Surgically compared sensitivities were 100 and 0 % for MRI and enteroclysis, for the detection of abscesses, and 83.3 and 17 % for the diagnosis of fistulae, respectively. Bowel wall thickening was more reliably detected with use of positive oral contrast media without intravenous enhancement (p < 0.001), whereas postcontrast negative oral contrast media allow for a superior detection (p < 0.001). T2-weighted sequences were necessary with use of negative oral contrast media, because loop abscesses may be masked. Magnetic resonance imaging should be performed in all patients with suspicion of extraintestinal complications, because the complications are more reliably detected by MRI. Negative oral contrast media show advantages with the use of intravenous contrast but can mask loop abscesses using only T1-weighted imaging. Received: 5 March 1999; Revised: 21 September 1999; Accepted: 3 February 2000     

Combination of signal intensity measurements of lesions in the peripheral zone of prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer

The aim of this study was to predict the benign or malignant nature of a prostatic lesion by defining a threshold value of signal intensity ratio and a limiting value of serum prostate-specific antigen (PSA) in patients with elevated PSA level. Twenty-six patients with elevated PSA level and no hypoechogenic lesions at endosonography underwent MR imaging using an endorectal body phased-array coil at 1.5 T (Siemens Magnetom Symphony). A T2-weighted turbo-spin-echo (TSE) pulse sequence was applied in a transverse orientation. Two radiologists evaluated the images. In the presence of a pathological finding they defined regions of interest (ROI) in the suspicious pathological area of the peripheral zone and in muscle for reference. The quotient of the two ROIs was calculated and then correlated with the actual PSA level. Diagnosis was confirmed by prostate biopsy. Ten of 12 patients with quotients smaller than 4 showed cancer at histology. Nine of 12 men with cancer proven by biopsy had PSA levels higher than 10 ng/ml. A significant difference (p < 0.001) was found between the quotients of cancer and quotients of chronic prostatitis, fibrosis, or glandular atrophy. The accuracy of tumor differentiation of the method was 77 %. Measurement of signal intensity quotients in the peripheral zone of the prostate in combination with knowledge of defined limits of PSA levels the technique could be helpful in detecting additional cancer areas for prostate biopsy. False-negative tumor results of standard sextant biopsy can be reduced. In men with high PSA values the method has a role in differentiating between patients who require prostate biopsy and those of clinical observation. Received: 2 February 2000, Revised: 11 May 2000, Accepted: 12 May 2000     

Tumors of the cardiac valves: imaging findings in magnetic resonance imaging, electron beam computed tomography, and echocardiography

We describe the findings from various cross-sectional imaging modalities in patients with cardiac valve adherent masses. The techniques are discussed, and imaging findings are compared with the results of cardiac surgery. All three patients had neurological symptoms and/or cardiac murmurs. Transthoracic and/or transesophageal echocardiography revealed the cardiac mass in all three. For differentiation of thrombus and cardiac neoplasm magnetic resonance imaging (MRI) was also performed in all three patients and electron-beam computed tomography (EBCT) in two. Fast segmented cine gradient-echo MRI techniques provided mass depiction in all patients, while T1-weighted spin-echo imaging failed in mass detection in one patient. None of the patients showed evidence of valve regurgitation or stenosis in flow sensitive cine MRI. EBCT excluded mass calcifications in both patients and reliably demonstrated the valve attached lesions. Although echocardiography is the modality of choice in evaluating cardiac masses and especially valve attached masses, MRI and EBCT provide additional information about tissue characteristics and allows an excellent overview of the cardiac and paracardiac morphology. Fast segmented cine gradient-echo MRI is especially able to depict even small tumors attached to rapidly moving cardiac valves, and valve competence can be easily assessed within the same examination. Received: 17 December 1998; Revision received: 1 June 1999; Accepted: 10 August 1999