Magnetic resonance imaging of apical left ventricular aneurysm and thinning associated with hypertrophic cardiomyopathy.
OBJECTIVE
To describe magnetic resonance imaging (MRI) findings of apical left ventricular (LV) aneurysm and thinning associated with hypertrophic cardiomyopathy (HCM).


METHODS
Thirty-nine patients with HCM underwent cine steady-state, free-precession and delayed contrast-enhanced, inversion-recovery, gradient-echo MRI. An apical LV aneurysm was defined as a thin-walled akinetic aneurysm, and an apical LV thinning was defined as the nonaneurysmal myocardial wall being thinner than 5 mm. The MRI findings were assessed in these patients.


RESULTS
Among the 39 patients, 2 showed apical aneurysm and 17 showed apical thinning. Cardiac MRI demonstrated that apical LV aneurysm was associated with myocardial hyperenhancement and a lower ejection fraction and that apical LV thinning was a common finding in HCM with asymmetrical septal hypertrophy. A few patients with apical thinning had some common features to apical aneurysm such as myocardial apical myocardial hyperenhancement.


CONCLUSIONS
Cardiac MRI was useful for the detection of apical LV aneurysm and thinning and the associated findings in HCM.
Amano
Yasuo
Y
Departments of Radiology, Nippon Medical School, Tokyo, Japan. yas-amano@nifty.com
Takayama
Morimasa
M
Kumita
Shinichiro
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006322:Heart Aneurysm / Q000209:etiology / Q000473:pathology*; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation
D003287:Contrast Media