Subendomyocardial perfusion abnormality and necrosis detected by magnetic resonance imaging in a patient with isolated noncompaction of the ventricular myocardium associated with ventricular tachycardia.

A 74-year-old man presented with left ventricular failure and nonsustained ventricular tachycardia. Coronary angiography revealed normal coronary arteries; left ventriculography showed hypokinesis of the lateral wall segment. The ejection fraction was 54%. Cine-magnetic resonance imaging showed a double-layered appearance on four-chamber view and marked trabeculations as well as intratrabecular recesses in the inferolateral segments on short-axis view, findings consistent with isolated noncompaction of the ventricular myocardium (INVM). Contrast-enhanced imaging revealed hypoperfusion and delayed enhancement of the endomyocardium in the inferolateral segments. Subendomyocardial perfusion abnormality and necrosis may constitute the diagnostic criteria of INVM.