Magnetic resonance imaging of apical left ventricular aneurysm and thinning associated with hypertrophic cardiomyopathy

J Comput Assist Tomogr. 2008 Mar-Apr;32(2):259-64. doi: 10.1097/RCT.0b013e318074fdbc.

Abstract

Purpose: 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.

Conclusion: Cardiac MRI was useful for the detection of apical LV aneurysm and thinning and the associated findings in HCM.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiomyopathy, Hypertrophic / complications*
  • Contrast Media / administration & dosage
  • Female
  • Heart Aneurysm / etiology
  • Heart Aneurysm / pathology*
  • Heart Ventricles / pathology*
  • Humans
  • Image Enhancement / methods
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Middle Aged
  • Observer Variation

Substances

  • Contrast Media