Sandbox: table diagnosis myxoa

The table below summarizes the findings that differentiate Cardiac Myxoma from other conditions that cause Emboli and hemorrhage:

Imaging Technique	Features	Description	Advantages/Disadvantages	Limitations
Two- or three-dimensional echocardiography	Echocardiography is usually the initial modality used for identification and evaluation of cardiac myxomas. Moreover, echocardiography can be useful to assess the mobility of the tumor, as it often protrude through valve flaps.	They appear as hyperechogenic lesions with a well-defined stalk,the tumor tends to protrude into the left ventricle (LV) in the case of left atrial myxoma.		Both transesophageal and transthoracic echocardiography provide only limited views of the mediastinum and cannot be used to evaluate extracardiac manifestations of disease. Transesophageal echocardiography is an invasive imaging technique. TT modality can be affected by the acustic window.
MRI	CMR imaging plays a significant role in the evaluation of cardiac masses and is of greatest value when echocardiographic findings are suboptimal or when the lesion has an atypical location or appearance.	Cardiac myxomas appear spherical or ovoid with lobular contours, irregular in shape. T1: tend to be low to intermediate signal, but areas of haemorrhage may be high T2: can be variable due to heterogeneity in tumour componants; e.g calcific components > low signal; myxomatous components > high signal GE (gradient echo): may show blooming of calcific components T1 C+ (Gd): shows enhancement (important discriminator from a thrombus) demonstrates uniform heterogeneous enhancement.	D	MRI cannot show calcification, and has a high susceptibility to motion artifact. CMR imaging is highly dependent on regular electrocardiographic rhythms and cardiac gating.
CT		Intracardiac heterogeneously low attenuating mass. The attenuation is usually lower than that of myocardium, coarse dystrophic calcification is common.	D	There is no real-time true imaging with CT and imaging planes are limited to those allowed by angulation of the gantry. There is no evaluation of small moving structures, such as the cardiac valves.
Angiography	Coronary angiography may be helpful to detect vascular supply of the tumor by the coronary arteries	The angiographic findings of cardiac myxoma demonstrate feeding vessels, contrast medium poolings, and clusters of tortuous vessels that correspond to tumor vasculature.	D	E
Chest x-ray	Chest x-ray has no particular findings associated with cardiac myxoma.	Results can be normal. Common findings include cardiomegaly, left atrial enlargement, vascular redistribution, prominent pulmonary trunk, and intracardiac tumoral calcification(rare).	D	E