Arrhythmogenic right ventricular dysplasia cardiac MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Among all the imaging modalities, MRI may be the most useful establishing the diagnosis of ARVD. Among patients with ARVD, fatty infiltration of the RV free wall can be visible on cardiac MRI. Fat has increased intensity in T1-weighted images. However, it may be difficult to differentiate intramyocardial fat and the epicardial fat that is commonly seen adjacent to the normal heart. Also, the sub-tricuspid region may be difficult to distinguish from the atrioventricular sulcus, which is rich in fat.

Cardiac MRI can visualize the extreme thinning and akinesis of the RV free wall. However, the normal RV free wall may be about 3 mm thick, making the test less sensitive.

MRI Examples

Shown below is the MRI of a patient with ARVD. This is a long axis view of the right ventricle. Note the transmural diffuse bright signal in the RV free wall on spin echo T1 (a) due to massive myocardial atrophy with fatty replacement (b).