Bands in the Heart: Multimodality Imaging Review

Abstract

Multiple bands and bandlike structures can be found within the cardiac chambers, which can be evaluated with various imaging modalities including echocardiography, CT, MRI, and invasive angiography. These bands can be classified as normal structures or normal variants, aberrant structures, or pathologic entities. Normal structures include the crista terminalis, taenia sagittalis, Chiari network, coumadin ridge, moderator band, papillary muscles, and chordae tendineae. Aberrant structures include aberrant papillary muscles, accessory chordae, false tendons, and accessory mitral valve tissue. Pathologic entities include double-chambered right ventricle, double-chambered left ventricle, cor triatriatum, and subaortic stenosis. Several types of bands are incidental findings discovered at imaging and do not produce clinical symptoms. However, some bands can mimic cardiac diseases, including masses. More importantly, some bands are pathologic entities that produce symptoms owing to hemodynamic consequences. Performing multimodality imaging helps the radiologist (a) identify, localize, and characterize the bands; (b) determine if they are normal structures, abnormal structures, or pathologic entities; (c) distinguish them from cardiac pathologic conditions; and (d) evaluate the secondary consequences of pathologic entities. This article reviews the various bands visualized within the cardiac chambers, as well as the role of imaging in depicting the bands, their appearances across various imaging modalities, and their clinical significance.

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“…However, associations have been established with septal defects, tetralogy of Fallot (TOF) and transposition of the great arteries. 1,3,4 The DCRV has a low pressure distal chamber (anatomically higher) and a high pressure proximal chamber (anatomically lower). 4,5 The chambers in DCRV are in series and cause eventual development of a gradient and a subinfundibular stenosis.…”

“…1,3,4 The DCRV has a low pressure distal chamber (anatomically higher) and a high pressure proximal chamber (anatomically lower). 4,5 The chambers in DCRV are in series and cause eventual development of a gradient and a subinfundibular stenosis. 3,4 The band is referred to as high when closer to the pulmonary valve and low when near the RV apex.…”

“…An aberrant moderator band also causes DCRV. 4 DCLV has an unknown etiology with various theories considered like postinflammatory or hypoplasia of the myocardial wall or failure of regression of fetal trabeculations. 3 Conventionally, seven subtypes of DCLV had been described with four types as an aneurysm or diverticulum from the apex/base and three separate subtypes with differently positioned endocardial thickening.…”

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“…4,5 The chambers in DCRV are in series and cause eventual development of a gradient and a subinfundibular stenosis. 3,4 The band is referred to as high when closer to the pulmonary valve and low when near the RV apex. This high pulmonary flow distal to the obstructing band differentiates DCRV from TOF.…”

“…There is also systolic flattening of the ventricular septum with RV hypertrophy. 4 DCRV can be caused by anomalous muscular bands or hypertrophied trabeculae. 5 The right ventricle normally has a nonobstructing moderator band which may have a complex branching attachment.…”