Cardiac Magnetic Resonance Imaging (MRI) has an interesting application in the evaluation of the right ventricle arrhythmogenic cardiomyopathy (RVAC). RVAC is a cardiac disease mainly involving the right ventricle, characterised by variable replacement of myocardium with adipose or fibroadipose tissue, dilatation of the right ventricle and kinetic alterations. The main risk is related to the possibility of sudden death due to ventricular tachyarrhythmias. The prevalence of the disease is low. The value of endocardial biopsy is unclear. More frequently, the diagnosis is obtained combining the imaging data and clinical signs. Main MRI findings are considered: fatty myocardial infiltration, thinning of the myocardium, dilatation of the right ventricle, evidence of diskinetic areas and/or bulging. It must be considered that: 1. ventricular arrhythmias originating in the right ventricle may arise in the presence or absence of structural heart disease; 2. ventricular tachycardia occuring in RVAC end in the ventricular tachycardia originating from the outflow tract (the distinction may be difficult); 3. fatty substitution may be difficult to see in the early stage (microscopic infiltration); false positive fatty substitution may be related to partial volume artefacts, respiratory, movements and erroneous gating. Today, volumetric and kinetic analyses may be obtained in a simple, accurate and fast way much better than with echocardiography. The new single and multi-shot Fast Spin Echo acquisition for tissue characterisation may be useful to avoid movement artefacts. Learning objectives: 1. Learn the MRI findings of RVAC. 2. Identify possible sources of error. 3. Explain acquisition techniques.

MRI assessment of right ventricular dysplasia

DI CESARE, Ernesto
2002-01-01

Abstract

Cardiac Magnetic Resonance Imaging (MRI) has an interesting application in the evaluation of the right ventricle arrhythmogenic cardiomyopathy (RVAC). RVAC is a cardiac disease mainly involving the right ventricle, characterised by variable replacement of myocardium with adipose or fibroadipose tissue, dilatation of the right ventricle and kinetic alterations. The main risk is related to the possibility of sudden death due to ventricular tachyarrhythmias. The prevalence of the disease is low. The value of endocardial biopsy is unclear. More frequently, the diagnosis is obtained combining the imaging data and clinical signs. Main MRI findings are considered: fatty myocardial infiltration, thinning of the myocardium, dilatation of the right ventricle, evidence of diskinetic areas and/or bulging. It must be considered that: 1. ventricular arrhythmias originating in the right ventricle may arise in the presence or absence of structural heart disease; 2. ventricular tachycardia occuring in RVAC end in the ventricular tachycardia originating from the outflow tract (the distinction may be difficult); 3. fatty substitution may be difficult to see in the early stage (microscopic infiltration); false positive fatty substitution may be related to partial volume artefacts, respiratory, movements and erroneous gating. Today, volumetric and kinetic analyses may be obtained in a simple, accurate and fast way much better than with echocardiography. The new single and multi-shot Fast Spin Echo acquisition for tissue characterisation may be useful to avoid movement artefacts. Learning objectives: 1. Learn the MRI findings of RVAC. 2. Identify possible sources of error. 3. Explain acquisition techniques.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11697/22321
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