Ventricular septal aneurysms in adults: findings of cardiac CT images and correlation with clinical features

BACKGROUND: With the increasing use of multidetector computed tomography (MDCT), the number of incidentally detected ventricular septal aneurysms (VSAs) in adults has increased. However, to date, there are not sufficient well-organized data regarding VSAs in adults on MDCT. PURPOSE: To evaluate the CT findings of ventricular septal aneurysms (VSAs) in adults and correlate the findings with clinical features. MATERIAL AND METHODS: We performed a retrospective review of the cardiac CT reports in our electronic database of 3402 patients who underwent ECG-gated cardiac CT scans using a 64-slice multidetector CT or dual-source CT from October 2006 to December 2009 at our institute. Among them, eight patients were diagnosed with a VSA. We evaluated the location, size, and morphology of VSAs on cardiac CT angiographies (CCTAs) and correlated the findings with the clinical features of the patients. RESULTS: On CCTAs, all eight patients were found to have VSAs in the membranous portion of the interventricular septum and toward the right ventricle. The VSAs were 10-22 mm at their longest diameter and had wide necks. The VSAs were lobulated along the outer margin and were incidental findings in all patients. Four of the eight patients had a conduction abnormality such as first-degree atrio-ventricular block or incomplete right bundle branch block seen on ECG, whereas the other four patients had normal ECGs. CONCLUSION: VSA in adults is usually detected incidentally. It is seen in the membranous portion of the interventricular septum with a lobulated shape on CCTA. It is occasionally associated with a conduction anomaly.