Arrhythmogenic right ventricular disease: MR imaging vs angiography

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Arrhythmogenic right ventricular disease (ARVD) is a genetic heart condition causing ventricular arrhythmias in young adults.
• It is characterized by right ventricular dysfunction and tachycardia, often diagnosed via angiography and biopsy.
• Current diagnostic methods have limitations in fully assessing ARVD's extent.

Purpose of the Study:

• To compare the efficacy of Magnetic Resonance (MR) imaging against traditional angiography in evaluating morphologic and functional abnormalities of the right ventricle in ARVD patients.

Main Methods:

• 36 ARVD patients (18 with inducible VT, 18 without) and 11 controls underwent ECG-gated spin-echo and cine gradient-echo MR imaging.
• Right ventricular morphology and function were assessed using MR imaging.
• MR findings were compared with results from angiography and biopsy.

Main Results:

• Patients with inducible VT (ARVD 1) showed significantly lower right ventricular ejection fraction and more pronounced regional wall abnormalities compared to ARVD 2 and controls.
• MR imaging detected fatty replacement in 33% of ARVD 1 patients, correlating with biopsy findings.
• MR imaging findings of abnormal right ventricular regions corresponded with angiographic results in 86% of cases.

Conclusions:

• MR imaging accurately assesses morphologic changes, tissue abnormalities, and global/regional dysfunction in ARVD.
• MR imaging shows promise as a clinical tool for ARVD diagnosis, grading, and follow-up.
• It may serve as a valuable alternative to angiography and biopsy in managing ARVD.