# All that Doesn’t Enhance Isn’t a Thrombus: Pitfalls Using Cardiac MRI TI 600 Sequence to Distinguish Between Cardiac Thrombus Versus Myxoma

## TL;DR

This case study highlights the limitations of using TI 600 MRI sequences to differentiate between heart thrombus and myxoma.

## Contribution

The paper presents a clinical case where TI 600 MRI misclassified a cardiac mass, emphasizing diagnostic pitfalls.

## Key findings

- TI 600 MRI showed no enhancement, suggesting a thrombus, but the mass was later identified as a myxoma.
- Delayed gadolinium enhancement sequences may not reliably distinguish between thrombus and tumor in cardiac MRI.

## Abstract

A 51-year-old male with a complicated medical history presented with shortness of breath. Preoperative workup confirmed the presence of a large atrial mass. However, delayed gadolinium enhancement CMR with long inversion time (TI 600) showed lack of enhancement, which was suggestive of a thrombus. During cardiac magnetic resonance imaging, delayed gadolinium enhancement sequences with long inversion time (TI 600) are commonly used to distinguish between an avascular thrombus versus a vascular tumor.