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Late enhancement: a new feature in MRI of arrhythmogenic right ventricular cardiomyopathy?

Peter Hunold1, Heinrich Wieneke, Oliver Bruder

  • 1Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany. peter.hunold@uniessen.de

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
|September 3, 2005
PubMed

Insights

Late enhancement (LE) on MRI can identify fibrous tissue in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. This advanced MRI technique aids in characterizing myocardial replacement in ARVC.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by fibrofatty myocardial replacement.
  • Accurate characterization of myocardial replacement is crucial for ARVC diagnosis and management.

Purpose of the Study:

  • To evaluate the utility of late enhancement (LE) in contrast-enhanced MRI (CE-MRI) for characterizing fibrofatty myocardial replacement in ARVC patients.
  • To determine if LE can identify specific tissue changes associated with ARVC.

Main Methods:

  • Fifteen patients with suspected ARVC underwent 1.5 T CE-MRI.
  • Standard cine and T1-weighted imaging were performed, followed by gadolinium-based contrast injection.
  • Inversion recovery gradient echo sequences were used to detect myocardial LE.

Main Results:

  • Seven out of 15 patients met the ESC criteria for ARVC.
  • LE was detected in the right ventricular myocardium of 5 ARVC patients (71%) and in the left ventricular myocardium of 2 patients.
  • Conventional T1-weighted imaging did not demonstrate fatty infiltration in ARVC patients with LE.

Conclusions:

  • Late enhancement is detectable in the myocardium of some ARVC patients.
  • LE on CE-MRI may represent intramyocardial areas of fibrous tissue, aiding in ARVC characterization.
  • LE offers a potential method for identifying pathological myocardial changes in ARVC.

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