Case Session 04: Miscellaneous (2018)-Improving recognition of intra-myocardial fat by CMR

Improving recognition of intra-myocardial fat by CMR

Video Transcription

Video Summary

A 51-year-old man presented with lightheadedness, presyncope, collapse, and ventricular tachycardia. Echocardiography showed mild ventricular dysfunction, and coronary angiography was normal. Cardiac MRI revealed mild ventricular dilation and impaired function, with septal high signal and focal low native T1 values suggesting fat or iron. Normal T2* excluded iron overload. Late gadolinium enhancement and fat-water separation imaging confirmed intramyocardial fat infiltration, especially in the septum. He was diagnosed with arrhythmogenic right ventricular cardiomyopathy spectrum disease with ventricular involvement. The case highlights that fat-water separation imaging can improve detection of intramyocardial fat when standard MRI sequences are inconclusive.

Keywords

arrhythmogenic right ventricular cardiomyopathy

ventricular tachycardia

cardiac MRI

intramyocardial fat infiltration

fat-water separation imaging