Non-compaction of the left ventricle

Case contributed by Dr Azza Elgendy


Acute heart failure.

Patient Data

Age: 30 years
Gender: Female

Extensive trabeculations within the left ventricle and thinning of the underlying compact myocardium. 

Steady-state free precession cine images in diastole. Abnormal (> 2.3:1) of non compacted to compacted myocardium in diastole.

Subendocardial increased signal.

Late gadolinium enhancement image shows subendocardial enhancement consistent with fibrosis at the apex.

Annotated image

The ratio of the non compaction myocardium to the compacted myocardium is 3 (1.5/.5)

Case Discussion

There is excessive trabeculation at left ventricular myocardium. 2.3:1 ratio of non compacted to compacted myocardium at end-diastole on SAXs CINE or LONG AXIS at the apex.

Differential diagnosis:

  • apical hypertrophic cardiomyopathy
  • dilated cardiomyopathy
  • late gadolinium enhancement imaging with long inversion time (~ 600 milliseconds) to exclude thrombus

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