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Figure 4 (A) A left ventricular apical mass (apical four-chamber view). (B) The mass hyper-enhanced with contrast, relative to the adjacent myocardium. (C) There was no enhancement of the mass or adjacent myocardium after a high-mechanical index impulse destroyed the contrast agent. (D) The surgical specimen was diagnosed as a hemangioma with abundant, dilated, thick-walled vessels, demonstrated by staining with factor VIII antibody. (E) Perfusion curves of video intensity over time demonstrated greater values for A and ß for the mass than for the adjacent myocardium.