What is the ideal test to evaluate ARVC?

• A. Echocardiography
• B. CMR
• C. CT
• D. Endomyocardial biopsy

Answer: (B)

Evaluating ARVC hinges on accurately characterizing the right ventricle. Cardiac MRI is ideal because it provides precise measurements of RV size and function, detects regional wall motion abnormalities and aneurysms, and offers tissue characterization with late gadolinium enhancement to identify fibrofatty replacement. This combination gives the most sensitive and specific noninvasive assessment for ARVC changes and aligns with how the disease is defined in imaging criteria. Other tests have limitations: echocardiography may miss subtle RV abnormalities due to visualization limits; CT gives good anatomy but less tissue detail and involves radiation; biopsy is invasive and can miss diseased areas due to sampling error. Thus, Cardiac MRI is the best choice to evaluate ARVC.