Keywords:
Cardiac, CT, CT-Quantitative, Image manipulation / Reconstruction, Diagnostic procedure, Dysplasias
Authors:
T. Ait Ali1, H. Nivet2, M. Salel1, G. Chevreau2, O. Corneloup1, V. Latrabe1, M. Montaudon1, F. Laurent1, H. Cochet1; 1Pessac/FR, 2Bordeaux/FR
Results
Patients characteristics
Characteristics of ARVC patients (46±15yrs,
7 women) are shown in Table 1.
All had definite ARVC diagnosis according to Task Force criteria.
In the control group (47±15yrs,
7 women),
all patients were referred at MDCT for the assessment of ascending aorta,
and had no history of palpitaion,
syncope,
or structural heart disease.
In the ischemic group (62±12yrs,
4 women),
all patients had history of myocardial infarction.
Reproducibility of MDCT measurements
The acquisition and processing of MDCT images were feasible in all patients.
Intra and inter-observer agreement for the quantification of RV fat was excellent (ICC=0.997,
P<0.0001 and ICC=0.993,
P<0.0001,
respectively).
Extent of fat in ARVC and non-ARVC
The extent of fat and the end-diastolic RV volume in each group are shown in Figure 2.
Fat extent was 16.5±6.1% in ARVC and 4.6±2.7% in non-ARVC (P<0.0001).
No significant difference was observed between control and ischemic groups (P=0.23).
A fat extent cut-off of 8.5% diagnosed ARVC with 94% sensitivity (95%CI 82 to 98%) and 92% specificity (95%CI 83 to 96%).
This diagnostic performance was higher than the one of RV end-diastolic volume (area under ROC curves 0.96±0.02 vs 0.88±0.04,
P=0.009).
Examples of fat measurements in ARVC and non-ARVC patients are shown in Figure 3.
Correlates of RV fat
In patients without ARVC,
fat did not correlate to age,
gender,
or RV volume.
Correlates of RV fat in ARVC are shown in Table 2.
Fat correlated to RV volume,
RV dysfunction,
epsilon waves,
inverted T waves in V1-V3,
and presence of PKP2 mutations.
Regional distribution of fat over the RV free wall:
The regional distribution of fat is illustrated in Figure 4.
Fat distribution differed between ARVC and non-ARVC patients,
postero-lateral RV wall being the most ARVC-specific area.