Bands in the heart: Multimodality imaging review

Multiple bands and bandlike structures can be found within the cardiac chambers, which can be evaluated with various imaging modalities including echocardiography, CT, MRI, and invasive angiography. These bands can be classified as normal structures or normal variants, aberrant structures, or pathologic entities. Normal structures include the crista terminalis, taenia sagittalis, Chiari network, coumadin ridge, moderator band, papillary muscles, and chordae tendineae. Aberrant structures include aberrant papillary muscles, accessory chordae, false tendons, and accessory mitral valve tissue. Pathologic entities include double-chambered right ventricle, double-chambered left ventricle, cor triatriatum, and subaortic stenosis. Several types of bands are incidental findings discovered at imaging and do not produce clinical symptoms. However, some bands can mimic cardiac diseases, including masses. More importantly, some bands are pathologic entities that produce symptoms owing to hemodynamic consequences. Performing multimodality imaging helps the radiologist (a) identify, localize, and characterize the bands; (b) determine if they are normal structures, abnormal structures, or pathologic entities; (c) distinguish them from cardiac pathologic conditions; and (d) evaluate the secondary consequences of pathologic entities. This article reviews the various bands visualized within the cardiac chambers, as well as the role of imaging in depicting the bands, their appearances across various imaging modalities, and their clinical significance.