| Dual-energy CT for the assessment of chronic myocardial infarction in patients with chronic coronary artery disease: comparison with 3-T MRI. | |
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MedLine Citation:
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PMID: 20729440 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Ralf W Bauer; J Matthias Kerl; Nadine Fischer; Thorsten Burkhard; Maya C Larson; Hanns Ackermann; Thomas J Vogl |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 195 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-23 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 639-46 Citation Subset: AIM; IM |
Affiliation:
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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:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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
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