CT has been shown to be accurate in the diagnosis and characterization of LV noncompaction using the standard MRI criteria of end-diastolic noncompacted LV myocardial thickness to compacted LV myocardial thickness ratio of >2.3 [92]. CT can show the abnormalities of stress-induced cardiomyopathy, including absence of delayed enhancement [93,94]. CTA Coronary There is no relevant literature to support the use of CTA coronary for the evaluation of nonischemic DCM or unclassified cardiomyopathy when ischemic cardiomyopathy has already been excluded. FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT as the first-line imaging modality in the evaluation of nonischemic or unclassified cardiomyopathy. One study found that nearly 50% of patients with unexplained cardiomyopathy and arrhythmia demonstrate focal inflammation in FDG-PET/CT, which is indicative of inflammatory cardiomyopathy [96]. Nonischemic Myocardial Disease MRI Chest There is no relevant literature to support the use of MRI chest for the evaluation of nonischemic DCM or unclassified cardiomyopathy. MRI Heart Function and Morphology In DCM, MRI helps in establishing the etiology and quantifying the abnormalities. Dilated ventricles, secondary tricuspid and/or mitral regurgitation due to annular dilation, regional ventricular dysfunction, ventricular wall thinning, and eccentric remodeling are seen. Myocardial infarct is diagnosed if there is subendocardial or transmural pattern of LGE in a vascular distribution. In idiopathic DCM with nonobstructed coronary arteries, linear or patchy mid myocardial LGE, primarily at the base and mid septum, is seen in 28% of patients. No LGE is seen in 59%. Subendocardial LGE is seen in 13% of these patients that is either due to atypical nonischemic fibrosis or silent ischemia from coronary embolus or recanalized plaque rupture [97].
Nonischemic Myocardial Disease with Clinical Manifestations Ischemic Cardiomyopathy Already Excluded . CT has been shown to be accurate in the diagnosis and characterization of LV noncompaction using the standard MRI criteria of end-diastolic noncompacted LV myocardial thickness to compacted LV myocardial thickness ratio of >2.3 [92]. CT can show the abnormalities of stress-induced cardiomyopathy, including absence of delayed enhancement [93,94]. CTA Coronary There is no relevant literature to support the use of CTA coronary for the evaluation of nonischemic DCM or unclassified cardiomyopathy when ischemic cardiomyopathy has already been excluded. FDG-PET/CT Heart There is no relevant literature to support the use of FDG-PET/CT as the first-line imaging modality in the evaluation of nonischemic or unclassified cardiomyopathy. One study found that nearly 50% of patients with unexplained cardiomyopathy and arrhythmia demonstrate focal inflammation in FDG-PET/CT, which is indicative of inflammatory cardiomyopathy [96]. Nonischemic Myocardial Disease MRI Chest There is no relevant literature to support the use of MRI chest for the evaluation of nonischemic DCM or unclassified cardiomyopathy. MRI Heart Function and Morphology In DCM, MRI helps in establishing the etiology and quantifying the abnormalities. Dilated ventricles, secondary tricuspid and/or mitral regurgitation due to annular dilation, regional ventricular dysfunction, ventricular wall thinning, and eccentric remodeling are seen. Myocardial infarct is diagnosed if there is subendocardial or transmural pattern of LGE in a vascular distribution. In idiopathic DCM with nonobstructed coronary arteries, linear or patchy mid myocardial LGE, primarily at the base and mid septum, is seen in 28% of patients. No LGE is seen in 59%. Subendocardial LGE is seen in 13% of these patients that is either due to atypical nonischemic fibrosis or silent ischemia from coronary embolus or recanalized plaque rupture [97].