Magnetic resonance and computed tomography imaging of arrhythmogenic right ventricular dysplasia

Arrhythmogenic right ventricular dysplasia (ARVD) is a familial cardiomyopathy that causes fibro-fatty replacement of the right ventricle (RV), leading to sudden death due to ventricular arrhythmias. The disease is an important cause of sudden death in individuals younger than 35 years of age. Structural and functional abnormalities of the RV constitute an important diagnostic criterion for the disease. Diagnosis of ARVD is often a challenge as conventional imaging modalities have significant limitations to visualize the RV. Recently, magnetic resonance imaging (MRI) and computed tomographic (CT) imaging have emerged as robust clinical tools for evaluation of myocardial pathology. In addition to providing morphologic and functional information, both imaging modalities have the ability to demonstrate intramyocardial fat, which is the pathological hallmark in ARVD. This article discusses the current status and role of MRI and CT imaging in the diagnosis of ARVD.