Defining left ventricular noncompaction using cardiac computed tomography

Manavjot S. Sidhu, Shanmugam Uthamalingam, Waleed Ahmed, Leif Christopher Engel, Yongkasem Vorasettakarnkij, Ashley M. Lee, Udo Hoffmann, Thomas Brady, Suhny Abbara, Brian B. Ghoshhajra

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29 Scopus citations

Abstract

PURPOSE:: Left ventricular noncompaction (LVNC) is a cardiomyopathy characterized by a distinctive 2-layered appearance of the myocardium because of increased trabeculation and deep intertrabecular recesses. Echocardiography serves as the initial noninvasive diagnostic test. Currently, magnetic resonance imaging (MRI) is increasingly being used to diagnose LVNC because of its improved temporal and spatial resolution. So far, no criteria have been proposed to define pathologic LVNC with the use of computed tomography (CT). MATERIALS AND METHODS:: We analyzed CT images using an American Heart Association 17-segment model in 8 patients previously diagnosed with LVNC by clinical diagnosis, echocardiography, and/or MRI, as well as in 11 patients with nonischemic dilated cardiomyopathy, 11 patients with hypertrophic cardiomyopathy, 10 patients with severe aortic stenosis, 9 patients with severe aortic regurgitation, 10 patients with left ventricular hypertrophy due to essential hypertension, and, additionally, in a control group of 20 patients who had normal CT scans without a history of cardiovascular disease. The distribution of LVNC was assessed by qualitative analysis of 17 myocardial segments for the presence or absence of any degree of noncompaction. Each segment was analyzed in each of the 3 end-diastolic long-axis views for the presence or absence of noncompaction, and the most prominent trabeculation was chosen for measurement. The left ventricular apex was excluded. Thickness of noncompacted and compacted myocardium was measured perpendicular to the compacted myocardium. The ratio of noncompacted to compacted (NC:C) myocardium was calculated for each segment. Receiver operating characteristics were used to generate cutoff values with sensitivity and specificity to distinguish the LVNC group from other groups. RESULTS:: An end-diastolic NC:C ratio >2.3 distinguished pathologic LVNC with 88% sensitivity and 97% specificity; positive and negative predictive values were 78% and 99%, respectively. CONCLUSIONS:: CT using the standard MRI NC:C ratio cutoff >2.3 accurately characterizes pathologic LVNC.

Original languageEnglish (US)
Pages (from-to)60-66
Number of pages7
JournalJournal of Thoracic Imaging
Volume29
Issue number1
DOIs
Publication statusPublished - Jan 2014

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Keywords

  • cardiac computed tomography
  • cardiomyopathy
  • left ventricular noncompaction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

Cite this

Sidhu, M. S., Uthamalingam, S., Ahmed, W., Engel, L. C., Vorasettakarnkij, Y., Lee, A. M., ... Ghoshhajra, B. B. (2014). Defining left ventricular noncompaction using cardiac computed tomography. Journal of Thoracic Imaging, 29(1), 60-66. https://doi.org/10.1097/RTI.0b013e31828e9b3d