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Evaluation of reperfused myocardial infarction by low-dose multidetector computed tomography using prospective electrocardiography (ECG)-triggering: comparison with magnetic resonance imaging.

Gweon HM, Kim SJ, Kim TH, Lee SM, Hong YJ, Rim SJ, Hong BK, Min PK, Yoon YW, Kwon HM - Yonsei Med. J. (2010)

Bottom Line: All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images.All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 +/- 10% vs. 22 +/- 10%, r = 0.935, p = 0.10).Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 +/- 17.8% vs. 4.3 +/- 2.1%, p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the potential of prospective electrocardiography (ECG)- gated 64-slice multidetector computed tomography (MDCT) for evaluation of myocardial enhancement, infarct size, and stent patency after percutaneous coronary intervention (PCI) with stenting in patients with myocardial infarction.

Materials and methods: Seventeen patients who were admitted with acute myocardial infarction were examined with prospective ECG-gated 64-slice cardiac MDCT and magnetic resonance (MR) imaging after reperfusion using PCI with stenting. Cardiac MDCT was performed with two different phases: arterial and delayed phases. We evaluated the stent patency on the arterial phase, and nonviable myocardium on the delayed phase of computed tomography (CT) image, and they were compared with the results from the delayed MR images.

Results: Total mean radiation dose was 7.7 +/- 0.5 mSv on the two phases of CT images. All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images. All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 +/- 10% vs. 22 +/- 10%, r = 0.935, p = 0.10). Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 +/- 17.8% vs. 4.3 +/- 2.1%, p < 0.001).

Conclusion: Prospective ECG-gated 64-slice MDCT provides the potential to evaluate myocardial viability on delayed phase as well as for stent patency on arterial phase with an acceptable radiation dose after PCI with stenting in patients with myocardial infarction.

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Linear regression analysis and Bland-Altman plots for infarct size between early arterial and delayed phase MDCT images. (A) Areas of hypoperfusion and hyperenhancement for early arterial phase and delayed phase MDCT images (Y = 6.296 + 0.928X, r = 0.911, p < 0.001). (B) Bland-Altman plots showing the relationship between early arterial MDCT images and delayed enhanced MDCT images. Mean differences (y-axes) between each pair [(mean MDCTd) - (mean MDCTa)] are plotted against the average values (x-axes) of the same pair [{(mean MDCTd) + (mean MDCTa)}/2]. These results showed that area of hyperenhancement on the delayed phase MDCT images was 5.2% larger than that of hypoenhancement on the arterial phase MDCT images (p < 0.05). MDCTd (a) = multidetector computed tomography, arterial phase (delayed phase). MDCT, multidetector computed tomography.
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Figure 3: Linear regression analysis and Bland-Altman plots for infarct size between early arterial and delayed phase MDCT images. (A) Areas of hypoperfusion and hyperenhancement for early arterial phase and delayed phase MDCT images (Y = 6.296 + 0.928X, r = 0.911, p < 0.001). (B) Bland-Altman plots showing the relationship between early arterial MDCT images and delayed enhanced MDCT images. Mean differences (y-axes) between each pair [(mean MDCTd) - (mean MDCTa)] are plotted against the average values (x-axes) of the same pair [{(mean MDCTd) + (mean MDCTa)}/2]. These results showed that area of hyperenhancement on the delayed phase MDCT images was 5.2% larger than that of hypoenhancement on the arterial phase MDCT images (p < 0.05). MDCTd (a) = multidetector computed tomography, arterial phase (delayed phase). MDCT, multidetector computed tomography.

Mentions: The mean area of hypoenhanced myocardium was 15 ± 10% (range, 0-34%) on the arterial phase of CT images and the mean area of hyperenhanced myocardium was 20 ± 10% (range, 4-38%) on the delayed phase of CT images. There was good correlation between the mean area of hypoenhanced myocardium on the arterial phase of CT images and the mean area of hyperenhanced myocardium on the delayed phases of CT images (Y = 6.296 + 0.928 X, r = 0.911, p = 0.001) with a mean difference of 5.2 ± 8.5% (p = 0.001) (Fig. 3) (Table 3).


Evaluation of reperfused myocardial infarction by low-dose multidetector computed tomography using prospective electrocardiography (ECG)-triggering: comparison with magnetic resonance imaging.

Gweon HM, Kim SJ, Kim TH, Lee SM, Hong YJ, Rim SJ, Hong BK, Min PK, Yoon YW, Kwon HM - Yonsei Med. J. (2010)

Linear regression analysis and Bland-Altman plots for infarct size between early arterial and delayed phase MDCT images. (A) Areas of hypoperfusion and hyperenhancement for early arterial phase and delayed phase MDCT images (Y = 6.296 + 0.928X, r = 0.911, p < 0.001). (B) Bland-Altman plots showing the relationship between early arterial MDCT images and delayed enhanced MDCT images. Mean differences (y-axes) between each pair [(mean MDCTd) - (mean MDCTa)] are plotted against the average values (x-axes) of the same pair [{(mean MDCTd) + (mean MDCTa)}/2]. These results showed that area of hyperenhancement on the delayed phase MDCT images was 5.2% larger than that of hypoenhancement on the arterial phase MDCT images (p < 0.05). MDCTd (a) = multidetector computed tomography, arterial phase (delayed phase). MDCT, multidetector computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908876&req=5

Figure 3: Linear regression analysis and Bland-Altman plots for infarct size between early arterial and delayed phase MDCT images. (A) Areas of hypoperfusion and hyperenhancement for early arterial phase and delayed phase MDCT images (Y = 6.296 + 0.928X, r = 0.911, p < 0.001). (B) Bland-Altman plots showing the relationship between early arterial MDCT images and delayed enhanced MDCT images. Mean differences (y-axes) between each pair [(mean MDCTd) - (mean MDCTa)] are plotted against the average values (x-axes) of the same pair [{(mean MDCTd) + (mean MDCTa)}/2]. These results showed that area of hyperenhancement on the delayed phase MDCT images was 5.2% larger than that of hypoenhancement on the arterial phase MDCT images (p < 0.05). MDCTd (a) = multidetector computed tomography, arterial phase (delayed phase). MDCT, multidetector computed tomography.
Mentions: The mean area of hypoenhanced myocardium was 15 ± 10% (range, 0-34%) on the arterial phase of CT images and the mean area of hyperenhanced myocardium was 20 ± 10% (range, 4-38%) on the delayed phase of CT images. There was good correlation between the mean area of hypoenhanced myocardium on the arterial phase of CT images and the mean area of hyperenhanced myocardium on the delayed phases of CT images (Y = 6.296 + 0.928 X, r = 0.911, p = 0.001) with a mean difference of 5.2 ± 8.5% (p = 0.001) (Fig. 3) (Table 3).

Bottom Line: All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images.All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 +/- 10% vs. 22 +/- 10%, r = 0.935, p = 0.10).Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 +/- 17.8% vs. 4.3 +/- 2.1%, p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the potential of prospective electrocardiography (ECG)- gated 64-slice multidetector computed tomography (MDCT) for evaluation of myocardial enhancement, infarct size, and stent patency after percutaneous coronary intervention (PCI) with stenting in patients with myocardial infarction.

Materials and methods: Seventeen patients who were admitted with acute myocardial infarction were examined with prospective ECG-gated 64-slice cardiac MDCT and magnetic resonance (MR) imaging after reperfusion using PCI with stenting. Cardiac MDCT was performed with two different phases: arterial and delayed phases. We evaluated the stent patency on the arterial phase, and nonviable myocardium on the delayed phase of computed tomography (CT) image, and they were compared with the results from the delayed MR images.

Results: Total mean radiation dose was 7.7 +/- 0.5 mSv on the two phases of CT images. All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images. All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 +/- 10% vs. 22 +/- 10%, r = 0.935, p = 0.10). Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 +/- 17.8% vs. 4.3 +/- 2.1%, p < 0.001).

Conclusion: Prospective ECG-gated 64-slice MDCT provides the potential to evaluate myocardial viability on delayed phase as well as for stent patency on arterial phase with an acceptable radiation dose after PCI with stenting in patients with myocardial infarction.

Show MeSH
Related in: MedlinePlus