Cardiac MR findings and potential diagnostic pitfalls in patients evaluated for arrhythmogenic right ventricular cardiomyopathy

Neda Rastegar, Jeremy R. Burt, Celia Corona Villalobos, Anneline S. te Riele, Cynthia Anne James, Brittney Murray, Hugh Calkins, Harikrishna Tandri, David A. Bluemke, Stefan Zimmerman, Ihab R Kamel

Research output: Contribution to journalArticle

Abstract

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a familial cardiomyopathy characterized by fibrofatty replacement of the myocardium, ventricular tachycardia, and ventricular dysfunction that affects primarily the right ventricle (RV). This disease is not common but can be seen more frequently in young adults, and clinical manifestations range from no symptoms to lethal arrhythmia and sudden death. The diagnosis of ARVC is challenging and is based on the recently revised international task force criteria. Given the strengths of cardiac magnetic resonance (MR) imaging for depicting the RV, this modality plays an important role in the diagnosis of ARVC. Functional and structural abnormalities of the RV depicted with cardiac MR imaging constitute major and minor criteria in the revised task force criteria. Since the ARVC program was established at our center in 1998, there has been an increased awareness of a number of normal variants that are commonly mis-interpreted as showing evidence for ARVC. On the basis of our clinical experience, the overdiagnosis of ARVC appears to reflect two fundamental problems: (a) a lack of awareness of diagnostic criteria that identify major and minor variables to be used for the diagnosis of ARVC, and (b) a lack of familiarity with the normal variants and mimics that may be misinterpreted as showing evidence of ARVC. The purpose of this article is to review the typical patterns of ventricular involvement in ARVC at cardiac MR imaging and to compare those with the patterns of normal variants and other diseases that can mimic ARVC.

Original languageEnglish (US)
Pages (from-to)1553-1571
Number of pages19
JournalRadiographics : a review publication of the Radiological Society of North America, Inc
Volume34
Issue number6
DOIs
StatePublished - Oct 1 2014

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Arrhythmogenic Right Ventricular Dysplasia
Magnetic Resonance Spectroscopy
Heart Ventricles
Magnetic Resonance Imaging
Advisory Committees
Ventricular Dysfunction
Ventricular Tachycardia
Sudden Death
Cardiomyopathies
Cardiac Arrhythmias
Young Adult
Myocardium

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

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title = "Cardiac MR findings and potential diagnostic pitfalls in patients evaluated for arrhythmogenic right ventricular cardiomyopathy",
abstract = "Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a familial cardiomyopathy characterized by fibrofatty replacement of the myocardium, ventricular tachycardia, and ventricular dysfunction that affects primarily the right ventricle (RV). This disease is not common but can be seen more frequently in young adults, and clinical manifestations range from no symptoms to lethal arrhythmia and sudden death. The diagnosis of ARVC is challenging and is based on the recently revised international task force criteria. Given the strengths of cardiac magnetic resonance (MR) imaging for depicting the RV, this modality plays an important role in the diagnosis of ARVC. Functional and structural abnormalities of the RV depicted with cardiac MR imaging constitute major and minor criteria in the revised task force criteria. Since the ARVC program was established at our center in 1998, there has been an increased awareness of a number of normal variants that are commonly mis-interpreted as showing evidence for ARVC. On the basis of our clinical experience, the overdiagnosis of ARVC appears to reflect two fundamental problems: (a) a lack of awareness of diagnostic criteria that identify major and minor variables to be used for the diagnosis of ARVC, and (b) a lack of familiarity with the normal variants and mimics that may be misinterpreted as showing evidence of ARVC. The purpose of this article is to review the typical patterns of ventricular involvement in ARVC at cardiac MR imaging and to compare those with the patterns of normal variants and other diseases that can mimic ARVC.",
author = "Neda Rastegar and Burt, {Jeremy R.} and {Corona Villalobos}, Celia and {te Riele}, {Anneline S.} and James, {Cynthia Anne} and Brittney Murray and Hugh Calkins and Harikrishna Tandri and Bluemke, {David A.} and Stefan Zimmerman and Kamel, {Ihab R}",
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AU - Burt, Jeremy R.

AU - Corona Villalobos, Celia

AU - te Riele, Anneline S.

AU - James, Cynthia Anne

AU - Murray, Brittney

AU - Calkins, Hugh

AU - Tandri, Harikrishna

AU - Bluemke, David A.

AU - Zimmerman, Stefan

AU - Kamel, Ihab R

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