6533b7cffe1ef96bd12583c3

RESEARCH PRODUCT

MRI in the Diagnosis of Right Ventricular Dysplasia

subject

description

ARVD is part of the group of cardiomyopathies characterised pathologically by fibrofatty replacement of the right ventricular myocardium and clinically by right ventricular arrhythmias of the LBBB pattern. Pathogenesis, prevalence, and aetiology are yet not fully known. The diagnosis of ARVD is based on the presence of structural, histological, electrocardiographic, and genetic factors. Therapeutic options include antiarrhythmic medication, catheter ablation, implantable cardioverter defibrillation, and surgery. Angiography and echocardiography lack sensitivity and specificity in the diagnosis of ARVD. MR imaging allows a three-dimensional evaluation of especially the right ventricle, and provides the most important anatomical, functional, and morphological criteria for diagnosis of ARVD within one single study. Although demonstration of morphological/functional abnormalities of the right ventricle, especially fat in the right ventricular myocardium, shows high specificity but low sensitivity, MR imaging appears to be the optimal imaging technique for detection and follow-up of clinically suspected ARVD. Positive MR imaging findings, based on the criteria of McKenna et al. [16], should be used as important additional criteria in the clinical diagnosis of ARVD, although negative MR imaging findings do not rule out ARVD.