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Characterization of acute and chronic myocardial infarcts by MDCT

Publication
CT Marketing Philips Healthcare

Comparison with contrast-enhanced MR

Gerber BL, Belge B, Legros GJ, Lim P, Poncelet A, Pasquet A, Gisellu G, Coche E, Vanoverschelde JL.

Results

In vivo infarct characterization by CE-MDCT was shown to be feasible between four and 20 minutes after contrast injection in seven pigs with MI. Subsequently, in 16 patients with acute MI and 21 patients with chronic MI, contrast patterns by CE-MDCT were related to CE-MR. Eighteen patients had hypo-enhanced regions on early CE-MDCT images at the time of coronary imaging, and 34 patients had hyper-enhanced regions on images acquired 10 minutes later. On a segmental basis, there was moderately good concordance of early hypo-enhanced regions (92%, kappa=0.54, P < 0.001) and late hyper-enhanced regions (82%, kappa=0.61, P < 0.001) between CE-MDCT and CE-MR. Absolute sizes of early hypo-enhanced (6 ± 16 versus 7 ± 16 g, P=0.25) and late hyper-enhanced (36 ± 34 versus 31 ± 40 g, P=0.14) regions were similar on CE-MDCT and CE-MR and were highly correlated (r=0.93, P < 0.001 and r=0.89, P < 0.001 respectively). In eight retrogradely perfused infarcted rabbit hearts, contrast kinetics of iomeprol were similar to gadodiamide, ie, slow wash in (8.7 ± 6.7 versus 1.2 ± 0.3 minutes, P < 0.001) in infarct core and slow washout (20 ± 12 versus 2.5 ± 0.5 minutes, P < 0.001) in both infarct core and rim compared with the remote region.

Conclusions

Because iodated contrast agents have similar kinetics in infarcted and non-infarcted myocardium as gadolinium DPTA, CE-MDCT can characterize acute and chronic MI with contrast patterns similar to CE-MR. CE-MDCT may thus provide important information on infarct size and viability at the time of noninvasive coronary imaging.

 

For more information about this publication, check out the PubMed listing for this article.


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Publication
Cardiac, contrast-enhanced, coronary angiography, coronary arteries, Myocardial infarction, Vascular
 

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