Magnetic resonance axial cine imaging without interslice gaps is a useful tool for the detection and characterization of regional wall motion abnormalities in the diagnostic evaluation of arrhythmogenic cardiomyopathy

Accurate detection of regional wall motion abnormalities (RWMA; akinesia, dyskinesia, dyssynchronous contraction) is important in the diagnosis of arrhythmogenic cardiomyopathy (ACM). We describe our initial experience with cardiac magnetic resonance (CMR) axial cine imaging without interslice gaps (axial no-gap cine imaging) which can be performed with existing imaging equipment and sequences. Fifty consecutive patients referred for CMR evaluation of possible (or follow-up) ACM were reviewed. In addition to conventional sequences, patients underwent free-breathing axial no-gap cine imaging to include the whole heart and the main pulmonary artery. Images were analyzed using interactive multi-planar reconstruction (MPR). When an abnormality was found or suspected, the images were reconstructed perpendicular to the involved ventricular wall, and the abnormal wall motion was cross-referenced to the findings shown in orthogonal planes. Of 50 patients reviewed, 10 (20%) had regional wall motion abnormalities. All cases with suspected abnormalities could be successfully reconstructed in the planes perpendicular to the involved ventricular wall. Six (12%) cases were follow-ups from previous abnormal exams and four (8%) were new abnormal studies. While abnormalities were able to be observed with conventional imaging in all 10 patients, axial no-gap cine imaging with MPR contributed to increased confidence or improved characterization of the abnormality in 9 of 10 (90%) patients. Until 4D whole heart cine imaging becomes commonly available in clinical practice, axial no-gap cine imaging with interactive multi-planar reconstruction improves confidence in the detection, visualization, and characterization of RWMA as criteria for arrhythmogenic cardiomyopathy. This approach eliminates the need for additional ad hoc multi-planar cine imaging prescribed in the area of the suspected or observed RWMA.