Quantification of left ventricular noncompaction and trabecular delayed hyperenhancement with cardiac MRI: correlation with clinical severity.
OBJECTIVE
The purpose of this study was to investigate whether MRI can quantify the severity and extent of left ventricular noncompaction and detect trabecular delayed hyperenhancement and whether doing so can show a relationship with clinical stage of disease.


METHODS
In a retrospective blinded study, nine patients with left ventricular noncompaction and 10 control subjects had cardiac MRI studies evaluated for the severity and extent of left ventricular noncompaction and the amount and degree of trabecular delayed hyperenhancement on a myocardial segment basis (16-segment model). Findings were correlated with parameters of clinical stage of disease.


RESULTS
Fifty-seven (39%) myocardial segments showed left ventricular noncompaction whereas 22 (17%) showed trabecular delayed hyperenhancement. Significant differences among clinical severity groups were noted in the severity and extent of left ventricular noncompaction at the mid (p < 0.05 and p < 0.005, respectively) and apical levels (p < 0.003 and p < 0.001, respectively), severity of trabecular delayed hyperenhancement at the mid (p < 0.04) and apical levels (p < 0.02), and amount of trabecular delayed hyperenhancement at the apical level (p < 0.006). The extent of left ventricular noncompaction and the amount and degree of trabecular delayed hyperenhancement correlated significantly with ejection fraction (EF) (r = -0.47, -0.53, -0.53, respectively, p < 0.05). The degree of trabecular delayed hyperenhancement was an independent predictor of EF (R2 = 0.30, p < 0.0001). Significant differences in the severity of trabecular delayed hyperenhancement were detected among patients with mild and those with moderate and severe clinical stage of disease (p < 0.0001).


CONCLUSIONS
Cardiac MRI shows trabecular delayed hyperenhancement in left ventricular noncompaction. Evaluating the extent and severity of left ventricular noncompaction and trabecular delayed hyperenhancement may improve the ability of the clinician to predict the clinical stage of disease.
Dodd
Jonathan D
JD
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Holmvang
Godtfred
G
Hoffmann
Udo
U
Ferencik
Maros
M
Abbara
Suhny
S
Brady
Thomas J
TJ
Cury
Ricardo C
RC
D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis*; D005260:Female; D006352:Heart Ventricles / Q000002:abnormalities* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*