January 1, 2003Cardiology
MR Imaging of Arrhythmogenic Right Ventricular Cardiomyopathy: Morphologic Findings and Interobserver Reliability
Key result
Cardiac MR imaging evaluation identified right ventricular chamber enlargement (58% vs 14%) and abnormal morphology (47% vs 15%) significantly more often in definite ARVC/D cases than controls (p<0.0001).
Why the study?
Which morphologic MR imaging features have the greatest interobserver reliability for diagnosing ARVC/D?
Population
45 sets of cardiac MR images evaluated by 8 radiologists and 5 cardiologists
Design
Cross-sectional
Authors
Discussion
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Implication
RV enlargement and abnormal morphology on cardiac MR may support ARVC/D diagnosis; leaves open prospective validation of diagnostic reliability.
Key Points
- This study aimed to identify morphologic MR imaging features with high interobserver reliability for diagnosing arrhythmogenic right ventricular cardiomyopathy (ARVC/D).
- Forty-five sets of cardiac MR images reviewed by 8 radiologists and 5 cardiologists.
- Assessment of images for right ventricle enlargement, morphology, and presence of high T(1) signal.
- Used Likert scale for formatted responses.
- Task Force ARVC/D cases had 58% RV chamber enlargement, significantly higher than suspected ARVC/D (12%) or non-ARVC/D (14%).
- When RV chamber size was reported as enlarged, the likelihood of diagnosing ARVC/D increased (chi(2)=33.98, p<0.0001).
- Abnormal RV morphology was noted in 47% of Task Force ARVC/D cases compared to 20% and 15% for suspected and non-ARVC/D cases, respectively.
Study Design
Type
Observational (n=45)
Structured PICO
Which morphologic MR imaging features have the greatest interobserver reliability for diagnosing ARVC/D?
P
Population
45 sets of cardiac MR images (7 definite ARVC/D by Task Force criteria, 6 controls, 32 suspected ARVC/D) evaluated by 8 radiologists and 5 cardiologists
I
Intervention
Evaluation of cardiac MR images for morphologic features (RV enlargement, RV abnormal morphology, LV enlargement, high T1 signal/fat presence and location)
O
Outcome
Interobserver reliability of morphologic MR imaging features for diagnosing ARVC/Dsurrogate
Main Result
p-value: p=<0.0001
RV size and shape abnormalities, rather than the presence of fat (high T1 signal), are the key reliable MR imaging discriminators for diagnosing ARVC/D.
Cite This Study
Bluemke et al. (2003) conducted an observational in Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) (n=45). Cardiac magnetic resonance (MR) imaging was evaluated on Presence of right ventricle enlargement and abnormal morphology (p=<0.0001). Cardiac MR imaging evaluation identified right ventricular chamber enlargement (58% vs 14%) and abnormal morphology (47% vs 15%) significantly more often in definite ARVC/D cases than controls (p<0.0001).