Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia

Suhny Abbara, Raymond Q. Migrino, David E. Sosnovik, Jeffrey A. Leichter, Thomas J. Brady, Godtfred Holmvang

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE. Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by intramyocardial fibrofatty change. Fat suppression performed during conventional spin-echo imaging has been used to confirm fatty infiltration. The utility of fat suppression for enhancing the interpretation of studies of suspected ARVD has not previously been formally tested. We investigated the value of fat suppression for enhancing the interpretation of intramyocardial fatty infiltration. MATERIALS AND METHODS. Twenty-six consecutive patients clinically referred for evaluation of possible ARVD underwent cardiac MRI. Two independent observers reviewed the images retrospectively. Intramyocardial areas (n = 101) that had increased signal intensity relative to normal surrounding myocardium on T1-weighted conventional spin-echo images ("index areas") were identified. The index areas were interpreted for presence of fatty infiltration using two sets of images: The first set was obtained without fat suppression, and the second set was obtained with fat suppression. Agreement between reviewers and confidence of interpretation were determined and compared. RESULTS. Interobserver agreement was measured using a 5-point scale: 1, definitely not fat; 2, probably not fat; 3, equivocal; 4, probably fat; and 5, definitely fat. The resulting kappa values were 0.35 for non-fat-suppressed images and 0.55 for fat-suppressed images. Interobserver kappa increased from 0.67 without fat suppression to 0.90 with fat suppression using a 3-point scale: 1, not fat; 2, equivocal; and 3, fat. Confidence in the diagnosis increased from 7.2 without fat suppression to 8.8 with fat suppression (p < 0.0001) on a 10-point scale ranging from 1, not confident, to 10, very confident. CONCLUSION. The use of fat-suppressed in addition to non-fat-suppressed conventional T1-weighted spin-echo imaging increased interobserver agreement and confidence in diagnosis and evaluation of intramyocardial fatty infiltration in patients who were suspected to have ARVD.

Original languageEnglish (US)
Pages (from-to)587-591
Number of pages5
JournalAmerican Journal of Roentgenology
Volume182
Issue number3
StatePublished - Mar 2004

Fingerprint

Arrhythmogenic Right Ventricular Dysplasia
Fats
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Abbara, S., Migrino, R. Q., Sosnovik, D. E., Leichter, J. A., Brady, T. J., & Holmvang, G. (2004). Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia. American Journal of Roentgenology, 182(3), 587-591.

Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia. / Abbara, Suhny; Migrino, Raymond Q.; Sosnovik, David E.; Leichter, Jeffrey A.; Brady, Thomas J.; Holmvang, Godtfred.

In: American Journal of Roentgenology, Vol. 182, No. 3, 03.2004, p. 587-591.

Research output: Contribution to journalArticle

Abbara, S, Migrino, RQ, Sosnovik, DE, Leichter, JA, Brady, TJ & Holmvang, G 2004, 'Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia', American Journal of Roentgenology, vol. 182, no. 3, pp. 587-591.
Abbara, Suhny ; Migrino, Raymond Q. ; Sosnovik, David E. ; Leichter, Jeffrey A. ; Brady, Thomas J. ; Holmvang, Godtfred. / Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia. In: American Journal of Roentgenology. 2004 ; Vol. 182, No. 3. pp. 587-591.
@article{eda6b6a099534fc0b333743155c2a553,
title = "Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia",
abstract = "OBJECTIVE. Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by intramyocardial fibrofatty change. Fat suppression performed during conventional spin-echo imaging has been used to confirm fatty infiltration. The utility of fat suppression for enhancing the interpretation of studies of suspected ARVD has not previously been formally tested. We investigated the value of fat suppression for enhancing the interpretation of intramyocardial fatty infiltration. MATERIALS AND METHODS. Twenty-six consecutive patients clinically referred for evaluation of possible ARVD underwent cardiac MRI. Two independent observers reviewed the images retrospectively. Intramyocardial areas (n = 101) that had increased signal intensity relative to normal surrounding myocardium on T1-weighted conventional spin-echo images ({"}index areas{"}) were identified. The index areas were interpreted for presence of fatty infiltration using two sets of images: The first set was obtained without fat suppression, and the second set was obtained with fat suppression. Agreement between reviewers and confidence of interpretation were determined and compared. RESULTS. Interobserver agreement was measured using a 5-point scale: 1, definitely not fat; 2, probably not fat; 3, equivocal; 4, probably fat; and 5, definitely fat. The resulting kappa values were 0.35 for non-fat-suppressed images and 0.55 for fat-suppressed images. Interobserver kappa increased from 0.67 without fat suppression to 0.90 with fat suppression using a 3-point scale: 1, not fat; 2, equivocal; and 3, fat. Confidence in the diagnosis increased from 7.2 without fat suppression to 8.8 with fat suppression (p < 0.0001) on a 10-point scale ranging from 1, not confident, to 10, very confident. CONCLUSION. The use of fat-suppressed in addition to non-fat-suppressed conventional T1-weighted spin-echo imaging increased interobserver agreement and confidence in diagnosis and evaluation of intramyocardial fatty infiltration in patients who were suspected to have ARVD.",
author = "Suhny Abbara and Migrino, {Raymond Q.} and Sosnovik, {David E.} and Leichter, {Jeffrey A.} and Brady, {Thomas J.} and Godtfred Holmvang",
year = "2004",
month = "3",
language = "English (US)",
volume = "182",
pages = "587--591",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "3",

}

TY - JOUR

T1 - Value of Fat Suppression in the MRI Evaluation of Suspected Arrhythmogenic Right Ventricular Dysplasia

AU - Abbara, Suhny

AU - Migrino, Raymond Q.

AU - Sosnovik, David E.

AU - Leichter, Jeffrey A.

AU - Brady, Thomas J.

AU - Holmvang, Godtfred

PY - 2004/3

Y1 - 2004/3

N2 - OBJECTIVE. Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by intramyocardial fibrofatty change. Fat suppression performed during conventional spin-echo imaging has been used to confirm fatty infiltration. The utility of fat suppression for enhancing the interpretation of studies of suspected ARVD has not previously been formally tested. We investigated the value of fat suppression for enhancing the interpretation of intramyocardial fatty infiltration. MATERIALS AND METHODS. Twenty-six consecutive patients clinically referred for evaluation of possible ARVD underwent cardiac MRI. Two independent observers reviewed the images retrospectively. Intramyocardial areas (n = 101) that had increased signal intensity relative to normal surrounding myocardium on T1-weighted conventional spin-echo images ("index areas") were identified. The index areas were interpreted for presence of fatty infiltration using two sets of images: The first set was obtained without fat suppression, and the second set was obtained with fat suppression. Agreement between reviewers and confidence of interpretation were determined and compared. RESULTS. Interobserver agreement was measured using a 5-point scale: 1, definitely not fat; 2, probably not fat; 3, equivocal; 4, probably fat; and 5, definitely fat. The resulting kappa values were 0.35 for non-fat-suppressed images and 0.55 for fat-suppressed images. Interobserver kappa increased from 0.67 without fat suppression to 0.90 with fat suppression using a 3-point scale: 1, not fat; 2, equivocal; and 3, fat. Confidence in the diagnosis increased from 7.2 without fat suppression to 8.8 with fat suppression (p < 0.0001) on a 10-point scale ranging from 1, not confident, to 10, very confident. CONCLUSION. The use of fat-suppressed in addition to non-fat-suppressed conventional T1-weighted spin-echo imaging increased interobserver agreement and confidence in diagnosis and evaluation of intramyocardial fatty infiltration in patients who were suspected to have ARVD.

AB - OBJECTIVE. Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by intramyocardial fibrofatty change. Fat suppression performed during conventional spin-echo imaging has been used to confirm fatty infiltration. The utility of fat suppression for enhancing the interpretation of studies of suspected ARVD has not previously been formally tested. We investigated the value of fat suppression for enhancing the interpretation of intramyocardial fatty infiltration. MATERIALS AND METHODS. Twenty-six consecutive patients clinically referred for evaluation of possible ARVD underwent cardiac MRI. Two independent observers reviewed the images retrospectively. Intramyocardial areas (n = 101) that had increased signal intensity relative to normal surrounding myocardium on T1-weighted conventional spin-echo images ("index areas") were identified. The index areas were interpreted for presence of fatty infiltration using two sets of images: The first set was obtained without fat suppression, and the second set was obtained with fat suppression. Agreement between reviewers and confidence of interpretation were determined and compared. RESULTS. Interobserver agreement was measured using a 5-point scale: 1, definitely not fat; 2, probably not fat; 3, equivocal; 4, probably fat; and 5, definitely fat. The resulting kappa values were 0.35 for non-fat-suppressed images and 0.55 for fat-suppressed images. Interobserver kappa increased from 0.67 without fat suppression to 0.90 with fat suppression using a 3-point scale: 1, not fat; 2, equivocal; and 3, fat. Confidence in the diagnosis increased from 7.2 without fat suppression to 8.8 with fat suppression (p < 0.0001) on a 10-point scale ranging from 1, not confident, to 10, very confident. CONCLUSION. The use of fat-suppressed in addition to non-fat-suppressed conventional T1-weighted spin-echo imaging increased interobserver agreement and confidence in diagnosis and evaluation of intramyocardial fatty infiltration in patients who were suspected to have ARVD.

UR - http://www.scopus.com/inward/record.url?scp=1442305675&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1442305675&partnerID=8YFLogxK

M3 - Article

VL - 182

SP - 587

EP - 591

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 3

ER -