Answer:
Left Ventricular Non Compaction
Findings:Hypertrabeculations with deep intertrabecular recesses noted in anterior and lateral walls of mid body and apex of left ventricle . The ratio of non compacted endocardial to compacted epicardial layer pf myocardium in diastolic phase is 3.1 No significant delayed hyperenhancement of myocardium seen. Relative hypokinesia of anterior and lateral walls of mid cavity and apex. Phase Contrast Velocity –Signal dropout reflecting mitral regurgitation
Discussion:Non-compaction of the myocardium is an uncommon unclassified cardiomyopathy, previously called "spongy myocardium", because of its appearance. Non-compaction of the myocardium was initially described as persistence of "sinusoids“ in the left ventricle in 1984 by Engberding and Bender The myocardium forms a loose network of avascular sponge-like meshwork of myocardial fibres and sinusoids,before the fifth week of intrauterine life. Compaction of the ventricular myocardium, with conversion of the intertrabecular spaces into capillaries, occurs during fifth and eighth gestational weeks, progressing from the epicardium towards the endocardium and from the base towards the apex. In non-compaction cardiomyopathy there is an arrest in this progress. The clinical manifestation of LVNC is highly variable, ranging from no symptoms to a progressive deterioration in cardiac function that results in congestive heart failure, arrhythmias, thromboembolic events, and sudden cardiac death The Peterson MR diagnostic criteria for LVNC: 1.Two distinct myocardial layers-Compacted epicardial layer and non compacted endocardial layer . 2.Marked trabeculations and deep intertrabecular recesses within non compacted layer 3.Ratio of trabeculated to compacted myocardium >2.3 in end diastole Since systole obliterates the sinusoids,it is recommended that the non-compacted and compacted myocardium layers be measured at end-diastole in contrast to echocardiography where it is measured in end systole
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Left Ventricular Non Compaction
Findings:Hypertrabeculations with deep intertrabecular recesses noted in anterior and lateral walls of mid body and apex of left ventricle . The ratio of non compacted endocardial to compacted epicardial layer pf myocardium in diastolic phase is 3.1 No significant delayed hyperenhancement of myocardium seen. Relative hypokinesia of anterior and lateral walls of mid cavity and apex. Phase Contrast Velocity –Signal dropout reflecting mitral regurgitation
Discussion:Non-compaction of the myocardium is an uncommon unclassified cardiomyopathy, previously called "spongy myocardium", because of its appearance. Non-compaction of the myocardium was initially described as persistence of "sinusoids“ in the left ventricle in 1984 by Engberding and Bender The myocardium forms a loose network of avascular sponge-like meshwork of myocardial fibres and sinusoids,before the fifth week of intrauterine life. Compaction of the ventricular myocardium, with conversion of the intertrabecular spaces into capillaries, occurs during fifth and eighth gestational weeks, progressing from the epicardium towards the endocardium and from the base towards the apex. In non-compaction cardiomyopathy there is an arrest in this progress. The clinical manifestation of LVNC is highly variable, ranging from no symptoms to a progressive deterioration in cardiac function that results in congestive heart failure, arrhythmias, thromboembolic events, and sudden cardiac death The Peterson MR diagnostic criteria for LVNC: 1.Two distinct myocardial layers-Compacted epicardial layer and non compacted endocardial layer . 2.Marked trabeculations and deep intertrabecular recesses within non compacted layer 3.Ratio of trabeculated to compacted myocardium >2.3 in end diastole Since systole obliterates the sinusoids,it is recommended that the non-compacted and compacted myocardium layers be measured at end-diastole in contrast to echocardiography where it is measured in end systole
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai