TY - JOUR
T1 - Evolving Role of Multidetector Computed Tomography in Evaluation of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
AU - Bomma, Chandra
AU - Dalal, Darshan
AU - Tandri, Harikrishna
AU - Prakasa, Kalpana
AU - Nasir, Khurram
AU - Roguin, Ariel
AU - Piccini, Jonathan
AU - Dong, Jun
AU - Mahadevappa, Mahesh
AU - Tichnell, Crystal
AU - James, Cynthia
AU - Lima, Joao A.C.
AU - Fishman, Elliot
AU - Calkins, Hugh
AU - Bluemke, David A.
N1 - Funding Information:
The Johns Hopkins ARVD program is supported by a private grant from the Bogle Foundation. This study is supported by Research Grants No. 1 UO1 HL65594-01A1 and HL 65594-02 from the National Institutes of Health, Bethesda, Maryland. Cardiomyopathy
PY - 2007/7/1
Y1 - 2007/7/1
N2 - The purpose of this study was to report 1 center's experience with multidetector computed tomography (MDCT) in the evaluation of patients suspected to have arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). RV dilatation/dysfunction is 1 of the most important criteria for establishing the diagnosis of ARVD/C. Cardiac magnetic resonance imaging (MRI) is the most preferred imaging modality for the diagnosis of ARVD/C. However, many patients with suspected ARVD/C have implantable cardioverter-defibrillators, prohibiting the use of MRI. Thirty-one patients (19 men; mean age 41 ± 12 years) referred for evaluation of known or suspected ARVD/C had a complete reevaluation including contrast-enhanced cardiac MDCT at the center. Two patients underwent both cardiac MRI and MDCT. Seventeen of 31 patients met Task Force criteria for ARVD/C and were confirmed to have ARVD/C. Multidetector computed tomographic images were analyzed for qualitative and quantitative characteristic findings of ARVD/C. Increased RV trabeculation (p <0.001), RV intramyocardial fat (p <0.001), and scalloping (p <0.001) were significantly associated with the final diagnosis of ARVD/C. RV volumes, RV inlet dimensions, and RV outflow tract surface area were increased in patients with ARVD/C compared with patients who did not meet the criteria. RV and left ventricular functional analysis was performed in 2 patients. In conclusion, cardiac MDCT has a strong potential to detect many qualitative and quantitative abnormalities of the right ventricle in patients with ARVD/C. Limitations include implantable cardioverter-defibrillators and motion artifacts, along with well-known radiation and contrast-induced reaction.
AB - The purpose of this study was to report 1 center's experience with multidetector computed tomography (MDCT) in the evaluation of patients suspected to have arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). RV dilatation/dysfunction is 1 of the most important criteria for establishing the diagnosis of ARVD/C. Cardiac magnetic resonance imaging (MRI) is the most preferred imaging modality for the diagnosis of ARVD/C. However, many patients with suspected ARVD/C have implantable cardioverter-defibrillators, prohibiting the use of MRI. Thirty-one patients (19 men; mean age 41 ± 12 years) referred for evaluation of known or suspected ARVD/C had a complete reevaluation including contrast-enhanced cardiac MDCT at the center. Two patients underwent both cardiac MRI and MDCT. Seventeen of 31 patients met Task Force criteria for ARVD/C and were confirmed to have ARVD/C. Multidetector computed tomographic images were analyzed for qualitative and quantitative characteristic findings of ARVD/C. Increased RV trabeculation (p <0.001), RV intramyocardial fat (p <0.001), and scalloping (p <0.001) were significantly associated with the final diagnosis of ARVD/C. RV volumes, RV inlet dimensions, and RV outflow tract surface area were increased in patients with ARVD/C compared with patients who did not meet the criteria. RV and left ventricular functional analysis was performed in 2 patients. In conclusion, cardiac MDCT has a strong potential to detect many qualitative and quantitative abnormalities of the right ventricle in patients with ARVD/C. Limitations include implantable cardioverter-defibrillators and motion artifacts, along with well-known radiation and contrast-induced reaction.
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U2 - 10.1016/j.amjcard.2007.02.064
DO - 10.1016/j.amjcard.2007.02.064
M3 - Article
C2 - 17599449
AN - SCOPUS:34250736050
SN - 0002-9149
VL - 100
SP - 99
EP - 105
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 1
ER -