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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
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Evolving role of multidetector computed tomography in evaluation of arrhythmogenic right ventricular

Chandra Bomma1, Darshan Dalal, Harikrishna Tandri

  • 1Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

The American Journal of Cardiology
|June 30, 2007
PubMed

Insights

Multidetector computed tomography (MDCT) shows promise in diagnosing arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) by identifying key right ventricular abnormalities. This imaging technique offers an alternative for patients with implantable cardioverter-defibrillators who cannot undergo cardiac MRI.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) diagnosis relies on identifying right ventricular (RV) dilatation and dysfunction.
  • Cardiac magnetic resonance imaging (MRI) is the preferred diagnostic tool for ARVD/C.
  • Implantable cardioverter-defibrillators (ICDs) in patients with suspected ARVD/C preclude the use of MRI.

Purpose of the Study:

  • To evaluate the utility of multidetector computed tomography (MDCT) in diagnosing ARVD/C.
  • To assess MDCT's ability to detect qualitative and quantitative abnormalities of the right ventricle in ARVD/C patients.

Main Methods:

  • Retrospective analysis of contrast-enhanced cardiac MDCT in 31 patients with suspected ARVD/C.
  • Evaluation of qualitative findings (trabeculation, intramyocardial fat, scalloping) and quantitative measurements (RV volumes, dimensions, surface area).
  • Comparison of MDCT findings with Task Force criteria for ARVD/C diagnosis.

Main Results:

  • Seventeen of 31 patients were confirmed to have ARVD/C.
  • Increased RV trabeculation, RV intramyocardial fat, and scalloping were significantly associated with ARVD/C (p <0.001).
  • Patients with ARVD/C showed increased RV volumes, inlet dimensions, and outflow tract surface area compared to controls.

Conclusions:

  • Cardiac MDCT effectively detects qualitative and quantitative RV abnormalities in ARVD/C.
  • MDCT serves as a viable alternative imaging modality for ARVD/C evaluation in patients with ICDs.
  • Limitations include ICD interference, motion artifacts, radiation exposure, and contrast reactions.

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