ARRHYTHMOGENIC RIGHT-VENTRICULAR DYSPLASIA - MR FEATURES

Arrhythmogenic right ventricular dysplasia (ARVD) is a heart disease c haracterized by a total or partial fat replacement of the myocardium. A total of 30 patients were studied with a suspected diagnosis of ARVD . Clinical criteria used for evaluation of ARVD were: (a) ventricular origin arrhythmias With a left bundle branch block configuration, (b) T-wave inversion in the anterior precordial leads, (c) ventricular kin etic alterations observed using echocardiography and angiography and ( d) cardiac failure when there are no pathologies attributable to other heart diseases. All patients had serial EKG and echocardiography test s. One third of patients underwent angiocardiography; 7 of 30 had Holt er; 7 of 30 had exercise test just to evaluate the effectiveness of th e anti-arrhythmic therapy. All patients underwent MRI examination. The following MRI criteria were used: (a) high-intensity areas indicating the fatty substitution of the myocardium, (b) ectasia of the right ve ntricular outflow tract, (c) dyskinetic bulges, (d) dilation of the ri ght ventricle and (e) enlargement of the right atrium. The diagnosis o f ARVD was classified as highly probable for patients manifesting at l east three positive criteria, probable with two positive criteria, dub ious with one and negative in the absence of all criteria. Highly prob able diagnosis of ARVD pas made in 8 patients, probable in 4, dubious in 7 and negative in 11. The MRI technique is very effective in the as sessment of ARVD. The MRI criteria may be helpful in the diagnosis of this condition.