Cardiac Magnetic Resonance Imaging in the Diagnosis and Prognosis of Conditions Associated with Sudden Cardiac Death

Abstract

Cardiac magnetic resonance (CMR) provides advantages over other cardiac imaging modalities when evaluating conditions associated with sudden cardiac death. CMR provides high-quality, cross-sectional images that enable accurate anatomical delineation, precise and reproducible measurements of right ventricular volumes and robust identification of non-compacted myocardium. Despite this, the diagnosis and prognosis of some conditions associated with sudden cardiac death remain challenging or indeed uncertain. This has implications for not just the decedent but also surviving family members in whom imaging screening for cardiovascular conditions may be of benefit.

In this thesis, I assessed the ability of CMR to prognosticate patients with right ventricular abnormality and clinical suspicion of arrhythmogenic right ventricular cardiomyopathy (ARVC). Using our novel technique based on CMR signal intensity, I calculated left ventricular noncompacted mass and determined the correlation to long term outcomes. Finally, I evaluated the accuracy of post mortem CMR to identify causes of unexplained death, when compared to traditional autopsy, and its potential role in the coronial process.