The value of magnetic resonance imaging for the diagnosis of arrhythmogenic right ventricular cardiomyopathy

Abstract

This study evaluated the diagnostic significance of a magnetic resonance imaging (MRI) based scoring model for identification of arrhythmogenic right ventricular cardiomyopathy (ARVC) in patients with MRI evidence of RV abnormalities. Fifty-three patients with RV myocardial abnormalities on MRI were divided into a group with ARVC 1 (n=17) and a group with other RV arrhythmias (n=37). Decision tree learning (DTL) and linear classification (based on a modified ARVC scoring model of major and minor criteria) were used to identify and assess MRI criterion information value, and to induce ARVC diagnostic rules. All major ARVC criteria were more frequent in the ARVC group. Among minor criteria regional RV hypokinesia, mild segmental RV dilatation, and prominent trabeculae were more frequent in the ARVC group while mild global RV dilatation was more frequent in the non-ARVC group. RV aneurysm achieved highest importance in ARVC diagnosis (predictive accuracy 76.8%). Better diagnostic accuracy (sensitivity 93.3%, specificity 89.5%) was achieved when the MRI score for the major and minor criteria reached threshold value of four: two major criteria, or one major and two minor, or four minor criteria. Combinations between major and minor criteria contributed to a statistically valid model for ARVC diagnosis.

Focal macroscopic fat deposition within the right ventricular wall in asymptomatic patients undergoing screening EBCT coronary calcium scoring examinations

“…An interesting finding was that an increase in the presence of myocardial fatty replacement was not significantly related to the patients' BMI. This differs from previous reports by Maskimovic and Imada which showed that obesity is significantly more common in cases of fatty replacement of RV [14,22].…”

“…We found that the presence of fat was associated with advanced patient age, a correlation also described by Fontarilan and Maksimovic [14,19]. A significant limitation of this work is that the Fig.…”

“…Still, several authors have noted that macroscopic fat may be present in patients without ARVD, and that the use of RV fat as a major imaging criterion for the diagnosis of ARVD can lead to erroneous interpretations [3,7,[11][12][13][14][15]. Also, in our clinical practice we have noted the presence of RV fat in many patients without any clinical evidence for ARVD.…”

Epidemiology of fat replacement of the right ventricular myocardium determined by multislice computed tomography using a logistic regression model

“…The condition, ARVC, has been diagnosed as involving fat deposits in the inter-ventricular septum, moderator band, or right ventricular wall, as well the enlargement of the right ventricle (RV); this diagnosis has often been performed by magnetic resonance imaging (MRI) or computed tomography (CT) [7,8].…”

Cardiovascular magnetic resonance in the evaluation of heart failure

“…CMR is able to obtain three-dimensional images to depict structural and functional abnormalities and so is well suited to demonstrate regional wall motion abnormalities, thinning and aneurysmal changes in the RV free wall, 23 increased RV and LV volumes, and increased T1 myocardial signal suggesting fatty infiltration. The role of LGE is currently being evaluated in this condition.…”