Korean J Radiol.  2012 Apr;13(2):244-248. 10.3348/kjr.2012.13.2.244.

Isolated Non-Compaction of the Left Ventricle in a Patient with New-Onset Heart Failure: Morphologic and Functional Evaluation with Cardiac Multidetector Computed Tomography

• Lee H
• Kim SY
• Schoepf UJ

• KMID: 1245391
• DOI: http://doi.org/10.3348/kjr.2012.13.2.244

Abstract

We describe a case of new-onset heart failure in a patient in whom cardiac CT enabled the non-invasive diagnosis of isolated non-compaction and associated functional abnormalities of the left ventricle with the concomitant evaluation of coronary arteries. This case highlights the utility of cardiac CT for the morphological and functional evaluation of the heart as a single imaging modality.

Keyword

Non-compaction; Myocardium; Computed tomography; Magnetic resonance imaging

MeSH Terms

Aged
Cardiac-Gated Imaging Techniques
Contrast Media/diagnostic use
Diagnosis, Differential
Disease Progression
Echocardiography
Electrocardiography
Heart Failure/*diagnosis
Humans
Image Interpretation, Computer-Assisted
Iohexol/analogs & derivatives/diagnostic use
Isolated Noncompaction of the Ventricular Myocardium/*diagnosis
Magnetic Resonance Imaging
Male
*Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Isolated non-compaction of left ventricle in 72 year-old-male with new-onset heart failure. A. Initial echocardiography with diastolic (right) and systolic (left) short axis image shows severe left ventricular systolic dysfunction and prominent trabeculation of left ventricular cavity. B. Curved multiplanar reformat of left anterior descending coronary artery based on cardiac CT reveals calcified plaque in proximal left anterior descending, thus causing luminal irregularities, but no significant stenosis (A). Calcified plaque at ostium of first diagonal branch (B) causes approximately 50% luminal stenosis. C. Findings from cardiac CT are in good agreement with prior coronary angiography. D, E. Short axis (D) and oblique long axis two-chamber (E) reformats of same cardiac CT data reconstructed in diastole demonstrate thickening of left ventricular wall, with prominent trabeculations and deep intertrabecular recesses. Note differentiation among non-compacted (black arrow) and compacted layers (white arrow). Ratio of distance from epicardial surface to trough of trabecular recesses over distance from epicardial surface to peak of trabeculation is less than 0.5 in involved area. F. Diastolic short axis reconstructions (left) show intertrabecular recesses filled with blood which are "milked" during systole (right). Ratio of end-systolic thickness of non-compacted layer divided by compacted layer is > 2. G-J. Cardiac MRI confirms extent and distribution of trabeculae and recesses. Short axis, steady-state, free procession MR images also show intertrabecular recesses filled with blood during diastole (G), which collapses during systole (H). Short axis inversion recovery true fast imaging with steady state precession image (I), however, shows no delayed enhancement within ventricular myocardium, but does show prominent trabeculation. (J) Diastolic (right) and systolic (left) short axis image at follow-up echocardiography demonstrates improvement of regional wall motion abnormalities with ejection fraction of 40%.

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