DOI:10.2214/AJR.07.3290
AJR 2008; 190:W273
© American Roentgen Ray Society
Delayed MRI Hyperenhancement in Noncompaction: Sign of Fibrosis Correlated with Clinical Severity
Giovanni Fazio,
Claudia Visconti,
Luciana D'Angelo,
Giuseppina Novo,
Salvatore Novo and colleagues
University of Palermo Palermo, Italy
WEB—This is a Web exclusive article.
Noncompaction of the ventricular myocardium is a rare congenital
cardiomyopathy resulting from an arrest in normal endomyocardial embryogenesis
[1–6].
In a recent study, Dodd et al.
[1] showed that MRI can
quantify the severity and extent of left ventricular noncompaction and detect
trabecular delayed hyperenhancement, and doing so can show a relationship with
clinical stage of disease. Their retrospective blinded study analyzed a small
series of nine patients with left ventricular noncompaction and 10 control
subjects. All underwent cardiac MRI studies that were evaluated for the
severity and extent of left ventricular noncompaction and the amount and
degree of trabecular delayed hyperenhancement on a myocardial segment basis
(16-segment model). The extent of left ventricular noncompaction and the
amount and degree of trabecular delayed hyperenhancement correlated
significantly with ejection fraction (EF). So the results of this study were
correlated with parameters (EF) of clinical stage of disease.
The findings of Dodd et al.
[1] are interesting and similar
to the results that we observed in our pediatric population. In our
experience, the late enhancement can be dependent on fibrosis, as in the other
proposed work, and the EF reduction can depend on the fibrosis
[2–6].
In our experience, as in that of Dodd et al.
[1], the late enhancement is
localized in the middle of the myocardium, and it can represent an important
sign of a poor prognosis. It would be interesting to know the long-term
prognoses of the affected patients of the Dodd et al. study and whether these
authors found patients with noncompaction but without late enhancement. In our
experience, only 50% of patients affected by noncompaction showed late
enhancement, and it was associated with a poor long-term prognosis and a low
EF.
References
- Dodd JD, Holmvang G, Hoffmann U, et al. Quantification of left
ventricular noncompaction and trabecular delayed hyperenhancement with cardiac
MRI: correlation with clinical severity. AJR2007; 189:974
-980[Abstract/Free Full Text]
- Fazio G, Pipitone S, Iacona MA, et al. Evaluation of diastolic
function by the tissue Doppler in children affected by non-compaction.
Int J Cardiol 2007;116
: e60-e62[CrossRef][Medline]
- Fazio G, Sutera L, Corrado G, Novo S. The chronic heart failure is
not so frequent in non-compaction. (reply to letter) Eur Heart
J 2007; 28:1269[Free Full Text]
- Fazio G, Corrado G, Pizzuto C, et al. Supraventricular arrhythmias
in noncompaction of left ventricle: is this a frequent complication?
Int J Cardiol 2007;[Epub ahead of
print]
- Fazio G, Corrado G, Zachara E, et al. Ventricular tachycardia in
non-compaction of left ventricle: is this a frequent complication?
Pacing Clin Electrophysiol 2007;30
: 544-546[CrossRef][Medline]
- Fazio G, Sutera L, Vernuccio F, et al. Heart failure and
cardiomyopathies: a case report [in Italian]. G Ital
Cardiol 2007; 8:129
-132
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Am. J. Roentgenol.,
April 1, 2008;
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