On cardiac MRI, the LGE (late gadolinium enhancement) pattern in hypertrophic cardiomyopathy (HCM) is MOST commonly located at:
- A Subendocardial distribution following a coronary territory
- B Transmural enhancement in the territory of the left anterior descending artery
- C Mid-myocardial patchy or at the right ventricular insertion points ✓
- D Epicardial linear enhancement along the lateral wall
Correct answer: C. Mid-myocardial patchy or at the right ventricular insertion points
Explanation
In HCM, LGE on cardiac MRI shows mid-myocardial patchy fibrosis, most characteristically at the right ventricular (RV) insertion points (the junctions of the interventricular septum and RV free wall). This pattern does not follow a coronary artery territory, distinguishing it from ischaemic fibrosis (which shows subendocardial or transmural enhancement in a coronary distribution). The degree of LGE correlates with risk of sudden cardiac death in HCM.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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