Comparison of postprocessing techniques for the detection of perfusion defects by cardiac computed tomography in patients presenting with acute ST-segment elevation myocardial infarction.

Comparison of postprocessing techniques for the detection of perfusion defects by cardiac computed tomography in patients presenting with acute ST-segment elevation myocardial infarction.

MedLine Citation:	PMID: 20579617 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	BACKGROUND: Despite rapid advances in cardiac computed tomography (CT), a strategy for optimal visualization of perfusion abnormalities on CT has yet to be validated. OBJECTIVE: We evaluated the performance of several postprocessing techniques of source data sets to detect and characterize perfusion defects in acute myocardial infarctions with cardiac CT. METHODS: Twenty-one subjects (18 men; 60 +/- 13 years) that were successfully treated with percutaneous coronary intervention for ST-segment myocardial infarction underwent 64-slice cardiac CT and 1.5 Tesla cardiac magnetic resonance imaging (MRI) scans after revascularization. Delayed enhancement MR images were analyzed to identify the location of infarcted myocardium. Contiguous short-axis images of the left ventricular myocardium were created from the CT source images with 0.75-mm multiplanar reconstruction (MPR), 5-mm MPR, 5-mm maximal intensity projection (MIP), and 5-mm minimum intensity projection (MinIP) techniques. Segments already confirmed to contain infarction by MRI were then evaluated qualitatively and quantitatively with CT. RESULTS: Overall, 143 myocardial segments were analyzed. On qualitative analysis, the MinIP and thick MPR techniques had greater visibility and definition than the thin MPR and MIP techniques (P < 0.001). On quantitative analysis, the absolute difference in Hounsfield unit attenuation between normal and infarcted segments was significantly greater for the MinIP (65.4 Hounsfield unit [HU]) and thin MPR (61.2 HU) techniques. However, the relative difference in Hounsfield unit attenuation was significantly greatest for the MinIP technique alone (95%; P < 0.001). Contrast to noise was greatest for the MinIP (4.2) and thick MPR (4.1) techniques (P < 0.001). CONCLUSION: The results of our current investigation found that MinIP and thick MPR detected infarcted myocardium with greater visibility and definition than MIP and thin MPR.

Authors:	Ian S Rogers; Ricardo C Cury; Ron Blankstein; Michael D Shapiro; Koen Nieman; Udo Hoffmann; Thomas J Brady; Suhny Abbara
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Publication Detail:	Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural Date: 2010-04-11
Journal Detail:	Title: Journal of cardiovascular computed tomography Volume: 4 ISSN: 1876-861X ISO Abbreviation: J Cardiovasc Comput Tomogr Publication Date: 2010 Jul-Aug
Date Detail:	Created Date: 2010-06-28 Completed Date: 2010-10-04 Revised Date: 2011-09-26
Medline Journal Info:	Nlm Unique ID: 101308347 Medline TA: J Cardiovasc Comput Tomogr Country: United States
Other Details:	Languages: eng Pagination: 258-66 Citation Subset: IM
Copyright Information:	Copyright 2010 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
Affiliation:	Department of Radiology and Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114-2750, USA.
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MeSH Terms
Descriptor/Qualifier:	Aged Angioplasty, Balloon, Coronary Contrast Media / diagnostic use Coronary Circulation* Female Gadolinium DTPA / diagnostic use Humans Magnetic Resonance Imaging Male Middle Aged Myocardial Infarction / physiopathology, radiography, therapy Myocardial Perfusion Imaging / methods Predictive Value of Tests Prospective Studies Radiographic Image Interpretation, Computer-Assisted / methods* Tomography, X-Ray Computed* Treatment Outcome Triiodobenzoic Acids / diagnostic use
Grant Support
ID/Acronym/Agency:	T32 HL076136-04/HL/NHLBI NIH HHS; T32 HL076136-05/HL/NHLBI NIH HHS; T32HL076136./HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:	0/Contrast Media; 0/Triiodobenzoic Acids; 80529-93-7/Gadolinium DTPA; 92339-11-2/iodixanol
Comments/Corrections
Comment In:	J Cardiovasc Comput Tomogr. 2010 Jul-Aug;4(4):274-5 [PMID: 20579618 ]

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