Arrhythmogenic right ventricular dysplasia cardiac MRI

Jump to navigation Jump to search

Arrhythmogenic right ventricular dysplasia Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Arrhythmogenic right ventricular dysplasia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

X - Ray

ECG

Cardiac MRI

Echocardiogram

Other Imaging Findings

Endomyocardial biopsy

Atuopsy

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Arrhythmogenic right ventricular dysplasia cardiac MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Arrhythmogenic right ventricular dysplasia cardiac MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Arrhythmogenic right ventricular dysplasia cardiac MRI

CDC on Arrhythmogenic right ventricular dysplasia cardiac MRI

Arrhythmogenic right ventricular dysplasia cardiac MRI in the news

Blogs onArrhythmogenic right ventricular dysplasia cardiac MRI

Directions to Hospitals Treating Arrhythmogenic right ventricular dysplasia

Risk calculators and risk factors for Arrhythmogenic right ventricular dysplasia cardiac MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Among all the imaging modalities, MRI may be the most useful establishing the diagnosis of ARVD.

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance[1] (DO NOT EDIT)

CMR may be used for assessment of patients with LV dysfunction or hypertrophy or suspected forms of cardiac injury not related to ischemic heart disease. When the diagnosis is unclear, CMR may be considered to identify the etiology of cardiac dysfunction in patients presenting with heart failure, including

  • evaluation of dilated cardiomyopathy in the setting of normal coronary arteries,
  • patients with positive cardiac enzymes without obstructive atherosclerosis on angiography,
  • patients suspected of amyloidosis or other infiltrative diseases,
  • hypertrophic cardiomyopathy,
  • arrhythmogenic right ventricular dysplasia, or
  • syncope or ventricular arrhythmia.

Fatty Infiltration

Among patients with ARVD, fatty infiltration of the RV free wall may be visible on cardiac MRI as a bright area of hyperenhancement. Fat has increased intensity in T1-weighted images which can be either focal or diffuse. However, the fat may be difficult to differentiate intramyocardial fat and the epicardial fat that is commonly seen adjacent to the normal heart. Also, the sub-tricuspid region may be difficult to distinguish from the atrioventricular sulcus, which is rich in fat.

Thinning of the RV Myocardium

Cardiac MRI can visualize the extreme thinning and akinesis of the RV free wall. However, the normal RV free wall may only be about 3 mm thick, rendering the test less sensitive.

RV Dilation and Regional Wall Motion Abnormalities of the RV

RV dilation and regional wall motion abnormalities in the RV may be present.

Indications for MRI

  1. Family history of ARVD or sudden cardiac death
  2. History of syncope, palpitations, with abnormalities of the right ventricle on echocardiography
  3. Ventricular tachycardia, particularly a right ventricular outflow tract tachycardia with a left bundle branch block appearance
  4. Arrhythmias in a young athlete

MRI Examples

Shown below is the MRI of a patient with ARVD. This is a long axis view of the right ventricle. Note the transmural diffuse bright signal in the RV free wall on spin echo T1 due to massive myocardial atrophy with fatty replacement.

Arvd MRI.jpg

Shown below is the same image with the area of fatty deposition outlined in red:

ARVD on MRI outlined in red.JPG

References

  1. American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA; et al. (2010). "ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents". Circulation. 121 (22): 2462–508. doi:10.1161/CIR.0b013e3181d44a8f. PMC 3034132. PMID 20479157.

Template:WH Template:WS