Korean J Radiol.  2011 Dec;12(6):686-692. 10.3348/kjr.2011.12.6.686.

Isolated Noncompaction of Ventricular Myocardium: a Magnetic Resonance Imaging Study of 11 Patients

• Yun H
• Zeng MS
• Jin H
• Yang S

• KMID: 1101922
• DOI: http://doi.org/10.3348/kjr.2011.12.6.686

Abstract

OBJECTIVE
To retrospectively summarize the cardiac magnetic resonance imaging (CMRI) findings of isolated noncompaction of ventricular myocardium (INVM).
MATERIALS AND METHODS
Eleven patients (M:F = 9:2; mean age, 35 years) were evaluated. Steady-state free precession (SSFP), fast spin echo (SE) sequence, SSFP cine imaging, and delayed enhanced inversion recovery spoiled gradient echo (IR-SPGR) sequence were used for showing abnormal myocardium, measuring ratio of noncompacted/compacted myocardium layers (NC/C ratio), and detecting myocardial viability. The left ventricle was divided into nine segments and a NC/C ratio > 2.3 in diastole was used as cutoff value in diagnosing left INVM. The right ventricle was assessed qualitatively.
RESULTS
Cardiac MRI indicated left INVM in seven patients, right INVM in one patient and biventricle INVM in three patients. Characteristic CMRI changes included prominent trabeculations, deep intertrabecular recesses and an increase in the NC/C ratio. The most frequently involved segments was left ventricular apex. Three patients had abnormal high signals within the trabecular structures on SE T2 weighted image. One ventricular aneurysm and one apical thrombus were also observed. Delayed enhancement was seen in six of nine patients with subendocardial and transmural patterns.
CONCLUSION
There are CMRI features that might be characteristic for INVM.

Keyword

Isolated noncompaction of ventricular myocardium; Cardiac magnetic resonance imaging; Cardiomyopathy

MeSH Terms

Adolescent
Adult
Female
Heart Aneurysm/complications/diagnosis
Heart Ventricles/pathology
Humans
Isolated Noncompaction of the Ventricular Myocardium/complications/*diagnosis
*Magnetic Resonance Imaging
Male
Middle Aged
Myocardium/pathology
Young Adult

Figure

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  Fig. 1 Spin echo sequence showing thin epicardial compacted zone and extremely thickened endocardial noncompacted zone in patient with biventricular isolated noncompaction of ventricular myocardium.

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  Fig. 2 Steady-state free precession sequence displaying two-layered structure of ventricular myocardium and high signals within trabecular recesses, suggestive of blood flow communicating with ventricular cavity.

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  Fig. 3 Steady-state free precession sequence at end of diastolic showing dilated left ventricle and ventricular aneurysm in left ventricular apex (A), septal segment is not affected in short-axis view of left ventricle (B).

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  Fig. 4 Apical thrombus (triangle arrow) coexisting with whole heart dilated and delayed enhancement is found in inversion recovery spoiled gradient echo sequence.

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