Evolving Role of Multidetector Computed Tomography in Evaluation of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

Chandra Bomma, Darshan Dalal, Harikrishna Tandri, Kalpana Prakasa, Khurram Nasir, Ariel Roguin, Jonathan Piccini, Jun Dong, Mahesh Mahadevappa, Crystal Tichnell, Cynthia James, Joao A.C. Lima, Elliot Fishman, Hugh Calkins, David A. Bluemke

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to report 1 center's experience with multidetector computed tomography (MDCT) in the evaluation of patients suspected to have arrhythmogenic right ventricular (RV) dysplasia/cardiomyopathy (ARVD/C). RV dilatation/dysfunction is 1 of the most important criteria for establishing the diagnosis of ARVD/C. Cardiac magnetic resonance imaging (MRI) is the most preferred imaging modality for the diagnosis of ARVD/C. However, many patients with suspected ARVD/C have implantable cardioverter-defibrillators, prohibiting the use of MRI. Thirty-one patients (19 men; mean age 41 ± 12 years) referred for evaluation of known or suspected ARVD/C had a complete reevaluation including contrast-enhanced cardiac MDCT at the center. Two patients underwent both cardiac MRI and MDCT. Seventeen of 31 patients met Task Force criteria for ARVD/C and were confirmed to have ARVD/C. Multidetector computed tomographic images were analyzed for qualitative and quantitative characteristic findings of ARVD/C. Increased RV trabeculation (p <0.001), RV intramyocardial fat (p <0.001), and scalloping (p <0.001) were significantly associated with the final diagnosis of ARVD/C. RV volumes, RV inlet dimensions, and RV outflow tract surface area were increased in patients with ARVD/C compared with patients who did not meet the criteria. RV and left ventricular functional analysis was performed in 2 patients. In conclusion, cardiac MDCT has a strong potential to detect many qualitative and quantitative abnormalities of the right ventricle in patients with ARVD/C. Limitations include implantable cardioverter-defibrillators and motion artifacts, along with well-known radiation and contrast-induced reaction.

Original languageEnglish (US)
Pages (from-to)99-105
Number of pages7
JournalAmerican Journal of Cardiology
Volume100
Issue number1
DOIs
StatePublished - Jul 1 2007

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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