Dual Source CT in left-ventricular hypertrophy [A] & in ARVCM [B]
Case history
[A] 58-year-old men with 2-vessel CAD and several cardiovascular risk factors, e.g. long-term arterial hypertension, dyslipoproteinemia, was referred for Dual Source CT angiography.
Question
Dual Source CT angiography for re-evaluation of coronary arteries and potential detection of coronary artery stenoses.
Diagnosis/Differential diagnosis
- [A] Left-ventricular hypertrophy (LVH) most likely due to long-term arterial hypertension; 2-vessel CAD with subendocardial scar in postero-lateral and posterior left-ventricular wall due to previous myocardial infarction.
- [B] In the second clinical case presented morphological and functional findings of DSCT are typical for arrhythmogenic right-ventricular cardiomyopathy (ARVCM).
Findings
[A] Concentric hypertrophy of entire LV myocardium [1, 2; arrows] without obstruction of LVOT. Circumscript thinning of postero-lateral and posterior LV myocardium with hypokinesis to akinesis in systolic images [2, 4; arrows]; LV-EF was reduced (51.2%). Cardiac MRI displayed hyperenhancement in postero-lateral and posterior left-ventricular myocardial wall following iv-application of Gd-DTPA [5].
Comments
[A] Dual Source CT provides clinically valuable information on LV morphology and global as well as regional function in patients with LV hypertrophy and chronic myocardial infarction.
[B] Typical features of ARVCM are right-ventricular (RV) dilatation, thinning of RV wall, hypertrophic RV trabeculae, and fibro-fatty replacement of RV myocardium.
 [1] |
 [2] |
 [3] |
 [4, 5] |
[A] [1-5] Diastolic (1, 3) and systolic (2, 4) DSCT image reformations in horizontal long axis (1, 2) and short-axis (3, 4) orientation, short-axis image reformation from contact-enhanced Magnetic Resonance Imaging (5).
 [6] |
 [7] |
[B] [6, 7] 42-year-old man with clinically and echocardiographically suspected ARVCM was referred for Dual Source CT angiography for non-invasive exclusion of CAD. Diastolic image reformations in horizontal long-axis orientation (6, “four chamber view”) and short-axis (7) orientation from Dual Source CT angiography.
Authors: Kai Uwe Jürgens, Harald Seifarth, Michael Puesken, Roman Fischbach
See corresponding news: Cardiac: Left/Right ventricular function
See corresponding procotol: Left/right ventricular function
See corresponding case: Dual Source CT preceding cardiac resynchronization therapy (CRT)
