MRI image sequencing of calcified myocardial masses: liquefaction necrosis of mitral annular calcification (LNMAC)

Conclusions LNMAC histopathology reveals a necrotic core (amorphous eosinophilic material) and surrounding inflammatory rim (macrophage and lymphocytic infiltration) with zonal calcification. By MRI this zone of cellular inflammation and edema manifests as the zone of peripheral hyperenhancement on the PSIR, HASTE, and IR TURBOFLASH sequences. Most benign or malignant cardiac tumors show high T2 weighted imaging intensity, and are myocardial isointense on T1 weighted imaging before contrast administration. In contrast, the hypointense central zone of liquefactive necrosis seen on T1 and T2 weighted sequences,