Myocardial Cleft, Crypt, Diverticulum, or Aneurysm? Does it Really Matter?

Afonso, Luís; Kottam, Anupama; Khetarpal, Vipin

doi:10.1002/clc.20466

Cited by 21 publications

(27 citation statements)

References 8 publications

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“…Clefts might be detected by cardiac MRI easier than the echocardiographic visualisation. For the accurate diagnosis of myocardial clefts, cardiac MRI is the best noninvasive imaging technique [2]. Consequently, myocardial cleft is a valuable imaging finding that will provide closely follow up for clinical HCM.…”

Section: Discussionmentioning

confidence: 99%

“…These cardiac zones are also transi-tion region of the myocytes may predispose to developmental disorder related to myocardial fiber disarray [1,2]. Cardiac magnetic resonance imaging (MRI) is a noninvasive imaging method has very good spatial resolution.…”

Section: Introductionmentioning

confidence: 99%

“…Also these studies showed a significant correlation between the myocar-dial clefts and the carriers of HCM gene mutations without clinical signs [1,4]. Clefts are described as a slit, V-or U-shaped extension of blood signal penetrating the myocardial thickness more than 50%, which seen in diastolic cine frames [2,5]. We aim to provide the cardiac computed tomogra-phy (CT) and MRI findings of a case with myocardial cleft.…”

Section: Introductionmentioning

confidence: 99%

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Incidentally Detected Myocardial Cleft: Cardiac Computed Tomography and Magnetic Resonance Imaging Findings

Görmeli¹,

Yağmur²,

Özdemi̇r³

et al. 2016

Med-Science

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidentally Detected Myocardial Cleft: Cardiac Computed Tomography and Magnetic Resonance Imaging Findings

Görmeli¹,

Yağmur²,

Özdemi̇r³

et al. 2016

Med-Science

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“…Both clefts and diverticula may contract with systole, but diverticula typically have a narrow neck with a wide outpouching, extending beyond the left ventricular cavity and myocardial margin. Clefts, in contrast, are fissure-like protrusions confined to compacted myocardium that are contractile and may obliterate during systole (7). Some myocardial clefts involve the full thickness of the interventricular septum and are detected only at diastole.…”

Section: Discussionmentioning

confidence: 99%

Association between myocardial hypertrophy and apical diverticulum: more than a coincidence?

Sivrioğlu¹,

Sağlam²,

Öztürk³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to investigate the possible association between the myocardial hypertrophy and the development of an apical diverticulum. MATERIALS AND METHODSWe retrospectively reviewed 786 multidetector computed tomography (MDCT) coronary angiography examinations (520 males, 266 females; mean age, 57±15 years; age range, 18-78 years). The end-diastolic left ventricle wall thickness was measured in all patients, and a wall thickness of 11 mm was determined to be the cut-off value for myocardial hypertrophy. The ventricular apex and subvalvular area were evaluated for ventricular diverticula. The difference between the apical diverticula in patients with and without myocardial hypertrophy was determined. RESULTSThere were 12 myocardial hypertrophy and nine apical diverticulum cases. Myocardial hypertrophy was observed in four (44%) of nine patients who had apical diverticula, and an apical diverticulum was observed in four (33%) of 12 patients who had myocardial hypertrophy. There was statistically significant difference for myocardial wall thickness between the apical diverticula in patients with myocardial hypertrophy and those without myocardial hypertrophy (P = 0.011). CONCLUSION Diagnosis of apical diverticula has become easier by using imaging modalities such as MDCT. There may be an association between myocardial hypertrophy and apical diverticulum.A pical diverticula are rare cardiac abnormalities consisting of a localized outpouching from the apex of the left ventricle. They are primarily congenital, occurring in isolation or in association with other abnormalities. Noncongenital cases are also seen in an isolated form in adults. A few cases have been described in which there is apparently an association between myocardial hypertrophy and apical diverticula (1-4).Recently, multidetector computed tomography (MDCT) has become a major diagnostic tool in cardiac imaging, showing both the coronary arteries and other cardiac and extracardiac structures, such as the myocardium, cardiac chambers, major vessels, and mediastinum (5). In this study, we investigated the association between myocardial hypertrophy and the development of apical diverticula. Materials and methods Patient selectionWe retrospectively reviewed 786 MDCT coronary angiography examinations performed in our department between October 2009 and May 2012, for the presence of apical diverticula.The institutional ethics committee approved this retrospective study (No: 2012-77 GATA Haydarpaa Teaching Hospital, ‹stanbul, Turkey). Written informed consent was obtained from all patients. Overall, there were 520 men and 266 women, with ages ranging from 18 to 78 years (mean, 57±15 years). The indications for MDCT coronary angiography were suspected coronary artery disease (n=681), coronary artery anomaly (n=36), coronary artery stent patency (n=27), and coronary artery bypass graft assessment (n=42). ImagingThe MDCT coronary angiography examinations were performed using a 64-MDCT scanner (Brilliance-64, Phillips Medical Systems, Eindh...

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“…They typically narrow or occlude during systole [10]. The blood inside the cleft can simulate myocardial scar in delayed enhancement images.…”

Section: Myocardial Cleftmentioning

confidence: 99%

Differentiation of myocardial scar from potential pitfalls and artefacts in delayed enhancement MRI

Türkbey

Nacif

Noureldin

et al. 2012

The British Journal of Radiology

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ABSTRACT. Delayed enhancement cardiac magnetic resonance (DE-CMR) imaging is used increasingly to identify and quantify focal myocardial scar. Our objective is to describe factors used in the interpretation of DE-CMR images and to highlight potential pitfalls and artefacts that mimic myocardial scar. Inversion recovery gradient recalled echo sequence is commonly accepted as the standard of reference for DE-CMR. There are also alternative sequences that can be performed in a single breath-hold or with free breathing. Radiologists need to be aware of factors affecting image quality, and potential pitfalls and artefacts that may generate focal hyperintense areas that mimic myocardial scar. Delayed enhancement cardiac magnetic resonance (DE-CMR) imaging can identify the presence, location and extent of myocardial scar (dense myocardial fibrosis) due to ischaemic and non-ischaemic heart diseases. This technique is also called late gadolinium-enhanced MRI (LGE-MRI), myocardial delayed enhanced (MDE) MRI and delayed hyperenhanced MRI (DHE-MRI) in the literature. DE-CMR has been shown to be more sensitive than other imaging methods in detecting small subendocardial infarctions [1] and has recently been used in population-based studies to assess the presence of myocardial scar [2,3]. The technique is relatively straightforward to implement, and images can be interpreted visually for the presence of myocardial scar (hyperenhanced region) without the need for post-processing.This article is intended to describe quality control procedures, factors affecting image quality, assessment of myocardial scar, and potential pitfalls and artefacts causing focal hyperintensities that mimic myocardial scar in delayed enhancement imaging.

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Myocardial Cleft, Crypt, Diverticulum, or Aneurysm? Does it Really Matter?

Cited by 21 publications

References 8 publications

Incidentally Detected Myocardial Cleft: Cardiac Computed Tomography and Magnetic Resonance Imaging Findings

Incidentally Detected Myocardial Cleft: Cardiac Computed Tomography and Magnetic Resonance Imaging Findings

Association between myocardial hypertrophy and apical diverticulum: more than a coincidence?

Differentiation of myocardial scar from potential pitfalls and artefacts in delayed enhancement MRI

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