Left and right ventricular diverticula: incidence and imaging findings on 256-slice multidetector computed tomography

Cardiac ventricular diverticulum is a rare congenital malformation. The entity is usually asymptomatic but can rarely cause complications and mimic other severe cardiac diseases on imaging. We evaluated the incidence and imaging findings of left and right ventricular diverticula on electrocardiogram-gated 256-slice multidetector computed tomography angiography (MDCTA).

We reviewed 324 patients (188 men; 136 women; mean age, 56 ± 15 y; age range, 7 to 91 y) who underwent retrospective (n=177) or prospective (n=147) electrocardiogram-gated cardiac CTA using a 256-slice MDCT scanner (Brilliance iCT, Phillips Healthcare; slice collimation, 2 × 128 × 0.625 mm; gantry rotation time, 270 ms) and searched for ventricular diverticula. We evaluated the incidence, size, location, and CT findings of the ventricular diverticula on the MDCTA images.

Eighteen ventricular diverticula were detected in 11 patients (incidence, 3.4%; 3 men; 8 women). Fifteen left ventricular diverticula were detected in 11 patients (incidence, 3.4%), and 3 right ventricular diverticula were found in 2 patients (incidence, 0.6%). The left ventricular diverticula were commonly located in the mid-inferoseptal (n=6) and mid-anteroseptal (n=4) walls. The right ventricular diverticula were located in the apical inferoseptal, mid-anteroseptal, and mid-inferoseptal walls. The mean maximal diameter of ventricular diverticula was 10 ± 3 mm (range, 7 to 16 mm). Multiple diverticula were seen in 5 patients (45%) and were commonly found clustered close to one another. Each of 13 ventricular diverticula with images obtained both in systole and diastole showed synchronous contraction with adjacent myocardium, and 4 diverticula completely closed in systole.

The incidence of left and right ventricular diverticula on 256-slice MDCTA was 3.4% and 0.6%, respectively, an incidence more frequent than in previous reports. The ventricular diverticula were commonly located in the mid-inferoseptal or mid-anteroseptal wall.