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What is the role of cardiac MRI in the diagnosis of left ventricular non-compaction?


The prevalence of left ventricular non-compaction is not well established. Using 2-D echocardiography, less than 1% of patients are diagnosed with this entity. Using cardiac MRI, approximately 3% of patients have evidence of LV non-compaction. This variance may be related to the difference in spatial resolution between these 2 imaging techniques. Using a large institutional cardiac imaging database, 2-D echo and cardiac MRI results were compared in patients with LV non-compaction.


Of 1,255 patients in our cardiac imaging database, 38 patients (3%) with a diagnosis of LV non-compaction were identified. Twenty-two of these 38 patients had undergone both 2-D echo and cardiac MRI exams. The reported diagnoses with each imaging modality were tabulated, along with measurements of left ventricular antero-septal and infero-posterior wall thickness for both modalities. The 2-D echo and cardiac MRI wall thickness dimensions were statistically compared using a paired sample t-test.


All 38 patients had a diagnosis of LV non-compaction on cardiac MRI, using criteria of non-compacted/compacted myocardium > 2.5 to 1.0 and deep LV trabeculations. None of the 22 patients with both 2-D echo and cardiac MRI exams had a diagnosis of LV non-compaction on their 2-D echo study. However, 15 of 22 patients (68%) had a diagnosis of LVH on their 2-D echo study, while only 3 had LVH on their cardiac MRI study. The mean ASWT on 2-D echo was 1.38 cm, while the mean ASWT on cMRI was 1.16 cm (p<0.005). The mean IPWT on 2-D echo was 1.31 cm, while the IPWT on cMRI was only 0.89 cm (p<0.001).


These data suggest that LV non-compaction, identifiable on cardiac MRI, is frequently diagnosed as LVH on 2-D echo. This discrepancy appears to be explained by the statistically significant difference in both antero-septal and infero-posterior LV wall thickness measurements between the 2 imaging modalities. It is suspected that this difference is related to the inferior spatial resolution of 2-D echo relative to cMRI. On the basis of these data, patients with LVH on 2-D echo should be considered for a cardiac MRI exam to determine if the increased LV wall thickness is truly LVH or an undiagnosed LV non-compaction cardiomyopathy.


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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Mikolich, J.R., Lisko, J., Boniface, N.C. et al. What is the role of cardiac MRI in the diagnosis of left ventricular non-compaction?. J Cardiovasc Magn Reson 15 (Suppl 1), P157 (2013).

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