Document Detail


Dual-energy CT for the assessment of chronic myocardial infarction in patients with chronic coronary artery disease: comparison with 3-T MRI.
MedLine Citation:
PMID:  20729440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this article is to compare the performance of dual-energy CT with that of 3-T MRI with late enhancement for the detection of chronic myocardial infarction during first-pass coronary CT angiography (CTA). SUBJECTS AND METHODS: Thirty-six patients underwent coronary CTA for the assessment of coronary bypass graft patency on a first-generation dual-source CT scanner in dual-energy mode. Gray-scale images (100 kV, 140 kV, and blended virtual 120 kV) were assessed for areas of hypodense myocardium during the arterial phase. In addition, a color-coded map of myocardial iodine distribution was calculated from the dual-energy data for perfusion analysis. Dual-energy CT data were compared with data from 3-T MRI with late enhancement, which served as the reference standard for scar detection using the American Heart Association's 17-segment model of the left ventricle. RESULTS: One hundred one (17%) of 612 myocardial segments in 22 (61%) of 36 patients showed late enhancement on MRI. Although myocardial iodine mapping was prone to artifacts, mostly arising from sternal wires (70% sensitivity), 100-kV gray-scale images showed the highest sensitivity (80%) for the detection of myocardial scar. Blended virtual 120-kV images with lower noise and higher resolution had the best diagnostic accuracy (77% sensitivity, 97% specificity, 85% positive predictive value, 96% negative predictive value, and 94% accuracy). CONCLUSION: Detection of chronic myocardial infarction on color-coded iodine distribution analysis with first-generation dual-energy CT is impeded by thoracic metallic devices. This group of patients benefits more from adequate blending of high- and low-kilovoltage gray-scale images. Further technical improvements are desirable to lower artifact burden and improve sensitivity on myocardial iodine distribution mapping.
Authors:
Ralf W Bauer; J Matthias Kerl; Nadine Fischer; Thorsten Burkhard; Maya C Larson; Hanns Ackermann; Thomas J Vogl
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  195     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-46     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic and Interventional Radiology, Clinic of the Goethe University, Haus 23C UG, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany. ralfwbauer@aol.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Artifacts
Chronic Disease
Contrast Media / diagnostic use
Coronary Angiography
Coronary Artery Bypass
Coronary Disease / pathology*,  radiography
Electrocardiography
Female
Heterocyclic Compounds / diagnostic use
Humans
Image Interpretation, Computer-Assisted
Iopamidol / analogs & derivatives,  diagnostic use
Male
Middle Aged
Myocardial Infarction / pathology*,  radiography,  surgery
Organometallic Compounds / diagnostic use
Predictive Value of Tests
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Heterocyclic Compounds; 0/Organometallic Compounds; 112188-16-6/gadoteridol; 62883-00-5/Iopamidol; 78649-41-9/iomeprol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Musculoskeletal ultrasound: how to treat calcific tendinitis of the rotator cuff by ultrasound-guide...
Next Document:  Adaptive Statistical Iterative Reconstruction: Assessment of Image Noise and Image Quality in Corona...