Publication
Delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI
Journal Paper/Review - May 15, 2011
Goetti Robert, Feuchtner Gudrun, Stolzmann Paul, Donati Olivio F, Wieser Monika, Plass André, Frauenfelder Thomas, Leschka Sebastian, Alkadhi Hatem
Units
PubMed
Doi
Citation
Type
Journal
Publication Date
Issn Electronic
Pages
Brief description/objective
OBJECTIVES
To evaluate the accuracy of high-pitch delayed enhancement (DE) CT for the assessment of myocardial viability with MRI as the reference standard.
METHODS
Twenty-four patients (mean age 66.9 ± 9.2 years) with coronary artery disease underwent DE imaging with 128-slice dual-source CT (prospective electrocardiography (ECG)-triggering) and MRI at 1.5 T. Two observers assessed DE transmurality per segment, and measured signal intensity (MRI) or attenuation (CT) in infarcted and healthy myocardium and noise in the left ventricular blood pool for calculating contrast-to-noise ratios (CNR).
RESULTS
75/408 (18.4%) segments in 18/24 patients (75.0%) showed DE in MRI, of which 28 segments in 10/24 (41.7%) patients were non-viable (scar tissue transmurality >50%). Sensitivity, specificity and accuracy of CT for diagnosis of non-viability were 60.7%, 96.8% and 94.4% per segment, and 90.0%, 92.9% and 91.7% per patient. CNR was significantly higher in MR (7.4 ± 3.0 vs. 4.6 ± 1.5; p = 0.018), and image noise significantly lower (11.6 ± 5.7 vs.15.0 ± 4.5; p = 0.019). Radiation dose of DECT was 0.89 ± 0.07 mSv.
CONCLUSIONS
CTDE imaging in the high-pitch mode enables myocardial viability assessment at a low radiation dose and good accuracy compared with MR, although associated with a lower CNR and higher noise.