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).
Observational (n=45)
Which morphologic MR imaging features have the greatest interobserver reliability for diagnosing ARVC/D?
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.
p-value: p=<0.0001
BACKGROUND: Magnetic resonance (MR) imaging is frequently used to diagnose arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, the reliability of various MR imaging features for diagnosing ARVC/D is unknown. The purpose of this study was to determine which morphologic MR imaging features have the greatest interobserver reliability for diagnosing ARVC/D. METHODS: Forty-five sets of films of cardiac MR images were sent to 8 radiologists and 5 cardiologists with experience in this field. There were 7 cases of definite ARVC/D as defined by the Task Force criteria. Six cases were controls. The remaining 32 cases had MR imaging because of clinical suspicion of ARVC/D. Readers evaluated the images for the presence of (a) right ventricle (RV) enlargement, (b) RV abnormal morphology, (c) left ventricle enlargement, (d) presence of high T(1) signal (fat) in the myocardium, and (e) location of high T(1) signal (fat) on a Likert scale with formatted responses. RESULTS: Readers indicated that the Task Force ARVC/D cases had significantly more (chi(2) = 119.93, d.f. = 10, p 0.05). CONCLUSIONS: Reviewers found that the size and shape of abnormalities in the RV are key MR imaging discriminates of ARVD. Subsequent protocol development and multicenter trials need to address these parameters. Essential steps in improving accuracy and reducing variability include a standardized acquisition protocol and standardized analysis with dynamic cine review of regional RV function and quantification of RV and left ventricle volumes.
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).