Abstract
Background
The accuracy of electrocardiogram-gated CT for diagnosing arrhythmogenic right ventricular
cardiomyopathy/dysplasia (ARVC/D) is uncertain.
Objective
We propose a comprehensive system for scoring characteristic CT findings to diagnose
ARVC/D and discuss its utility.
Methods
Seventy-seven patients (mean age, 43.1 years; 48 male) diagnosed with ARVC/D or with
suspected ARVC/D on the basis of ventricular tachyarrhythmias underwent CT with and
without contrast enhancement. We retrospectively graded characteristic CT findings
(fatty tissue, bulging appearance, and dilatation of the right ventricle) as minor
(1 point) or major (2 points) and then validated our scoring system’s utility for
diagnosing ARVC/D with the use of the modified 2010 Task Force criteria as the reference
standard.
Results
We diagnosed 27 of 77 patients with ARVC/D (23 definite, 4 borderline), observing
each CT finding more often in patients with ARVC/D than in patients without ARVC/D:
fatty tissue, 74.1% versus 12.0%; bulging appearance, 74.1% versus 34.0%; and RV dilatation,
92.6% versus 44.0%. However, observation of each finding in both groups could cause
false positive diagnosis. Recursive partitioning analysis showed the superiority of
our CT scoring system over methods that used each CT finding and CT findings without
fatty tissue for distinguishing ARVC/D and non-ARVC/D. For overall (definite and borderline)
and definite ARVC/D diagnosis, sensitivities were 77.8% and 87.0%, specificities were
96.0% and 94.4%, positive predictive values were 91.3% and 87.0%, negative predictive
values were 88.9% and 94.4%, and accuracies were 89.6% and 92.2%, respectively.
Conclusions
Our CT scoring system showed excellent diagnostic ability and might aid differentiation
of ARVC/D from ventricular tachyarrhythmias.
Keywords
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Article info
Publication history
Published online: June 03, 2013
Accepted:
May 26,
2013
Received in revised form:
April 15,
2013
Received:
January 18,
2013
Identification
Copyright
© 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
