Published online before print February 6, 2006, doi: 10.1161/CIRCULATIONAHA.104.529511
(Circulation. 2006;113:823-833.)
© 2006 American Heart Association, Inc.
Imaging |
Characterization of Acute and Chronic Myocardial Infarcts by Multidetector Computed Tomography
Comparison With Contrast-Enhanced Magnetic Resonance
From the Division of Cardiology (B.L.G., B.B., G.J.L., P.L., A.P., G.G., J.-L.J.V.), Laboratory of Experimental Surgery (A.P.), and Division of Radiology (E.C.), Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium.
Correspondence to Bernhard L. Gerber, MD, PhD, Department of Cardiology, Cliniques Universitaires St. Luc UCL, Av Hippocrate 10/2806, B-1200 Woluwe St. Lambert, Belgium. E-mail Bernhard.gerber{at}clin.ucl.ac.be
Received December 24, 2004; revision received December 8, 2005; accepted December 9, 2005.
Background— We evaluated whether contrast-enhanced multidetector computed tomography (CE-MDCT) might characterize myocardial infarct (MI) with patterns similar to those obtained by contrast-enhanced magnetic resonance (CE-MR) and studied the underlying mechanisms.
Methods and Results— In vivo infarct characterization by CE-MDCT was shown to be feasible between 4 and 20 minutes after contrast injection in 7 pigs with MI. Subsequently, in 16 patients with acute MI and 21 patients with chronic MI, contrast patterns by CE-MDCT were related to CE-MR. Eighteen patients had hypoenhanced regions on early CE-MDCT images at the time of coronary imaging, and 34 patients had hyperenhanced regions on images acquired 10 minutes later. On a segmental basis, there was moderately good concordance of early hypoenhanced regions (92%, 
=0.54, P<0.001) and late hyperenhanced regions (82%, =0.61, P<0.001) between CE-MDCT and CE-MR. Absolute sizes of early hypoenhanced (6±16 versus 7±16 g, P=0.25) and late hyperenhanced (36±34 versus 31±40 g, P=0.14) regions were similar on CE-MDCT and CE-MR and were highly correlated (r=0.93, P<0.001 and r=0.89, P<0.001 respectively). In 8 retrogradely perfused infarcted rabbit hearts, contrast kinetics of iomeprol were similar to gadodiamide, ie, slow wash in (8.7±6.7 versus 1.2±0.3 minutes, P<0.001) in infarct core and slow washout (20±12 versus 2.5±0.5 minutes, P<0.001) in both infarct core and rim compared with the remote region.
Conclusions— Because iodated contrast agents have similar kinetics in infarcted and noninfarcted myocardium as gadolinium DPTA, CE-MDCT can characterize acute and chronic MI with contrast patterns similar to CE-MR. CE-MDCT may thus provide important information on infarct size and viability at the time of noninvasive coronary imaging.
CLINICAL PERSPECTIVE
Related Article:
-
Issue Highlights
Circulation 2006 113: 763.[Extract] [Full Text]
This article has been cited by other articles:
 |
|
 |
|
  G. Bastarrika, Y. S. Lee, W. Huda, B. Ruzsics, P. Costello, and U. J. Schoepf CT of Coronary Artery Disease Radiology, November 1, 2009; 253(2): 317 - 338. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Mahnken, P. Bruners, C. M. Bornikoel, N. Kramer, and R. W. Guenther Assessment of Myocardial Edema by Computed Tomography in Myocardial Infarction J. Am. Coll. Cardiol. Img., October 1, 2009; 2(10): 1167 - 1174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Blankstein, L. D. Shturman, I. S. Rogers, J. A. Rocha-Filho, D. R. Okada, A. Sarwar, A. V. Soni, H. Bezerra, B. B. Ghoshhajra, M. Petranovic, et al. Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J. Am. Coll. Cardiol., September 15, 2009; 54(12): 1072 - 1084. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K-R Chiou, W-C Huang, N-J Peng, Y-L Huang, S-H Hsiao, K-H Chen, and M-T Wu Dual-phase multi-detector computed tomography assesses jeopardised and infarcted myocardium subtending infarct-related artery early after acute myocardial infarction Heart, September 15, 2009; 95(18): 1495 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Rodriguez-Granillo, M. A. Rosales, S. Baum, P. Rennes, C. Rodriguez-Pagani, V. Curotto, C. Fernandez-Pereira, C. Llaurado, G. Risau, E. Degrossi, et al. Early Assessment of Myocardial Viability by the Use of Delayed Enhancement Computed Tomography After Primary Percutaneous Coronary Intervention J. Am. Coll. Cardiol. Img., September 1, 2009; 2(9): 1072 - 1081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. de Feyter and K. Nieman Rediscovery of Infarct Imaging by Cardiac CT J. Am. Coll. Cardiol. Img., September 1, 2009; 2(9): 1082 - 1084. [Full Text] [PDF]
|
|
|
|
|
|
R Rubinshtein, T D Miller, E E Williamson, J Kirsch, R J Gibbons, A N Primak, C H McCollough, and P A Araoz Detection of myocardial infarction by dual-source coronary computed tomography angiography using quantitated myocardial scintigraphy as the reference standard Heart, September 1, 2009; 95(17): 1419 - 1422. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Lautamaki, K. H. Schuleri, T. Sasano, M. S. Javadi, A. Youssef, J. Merrill, S. G. Nekolla, M. R. Abraham, A. C. Lardo, and F. M. Bengel Integration of Infarct Size, Tissue Perfusion, and Metabolism by Hybrid Cardiac Positron Emission Tomography/Computed Tomography: Evaluation in a Porcine Model of Myocardial Infarction Circ Cardiovasc Imaging, July 1, 2009; 2(4): 299 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. H. Schuleri, M. Centola, R. T. George, L. C. Amado, K. S. Evers, K. Kitagawa, A. L. Vavere, R. Evers, J. M. Hare, C. Cox, et al. Characterization of peri-infarct zone heterogeneity by contrast-enhanced multidetector computed tomography: a comparison with magnetic resonance imaging. J. Am. Coll. Cardiol., May 5, 2009; 53(18): 1699 - 1707. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Habis, A Capderou, A Sigal-Cinqualbre, S Ghostine, S Rahal, J Y Riou, P Brenot, C Y Angel, and J F Paul Comparison of delayed enhancement patterns on multislice computed tomography immediately after coronary angiography and cardiac magnetic resonance imaging in acute myocardial infarction Heart, April 1, 2009; 95(8): 624 - 629. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Holz, R. Lautamaki, T. Sasano, J. Merrill, S. G. Nekolla, A. C. Lardo, and F. M. Bengel Expanding the Versatility of Cardiac PET/CT: Feasibility of Delayed Contrast Enhancement CT for Infarct Detection in a Porcine Model J. Nucl. Med., February 1, 2009; 50(2): 259 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W P Bandettini and A E Arai Advances in clinical applications of cardiovascular magnetic resonance imaging Heart, November 1, 2008; 94(11): 1485 - 1495. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-B. le Polain de Waroux, A.-C. Pouleur, C. Goffinet, A. Pasquet, J.-L. Vanoverschelde, and B. L. Gerber Combined coronary and late-enhanced multidetector-computed tomography for delineation of the etiology of left ventricular dysfunction: comparison with coronary angiography and contrast-enhanced cardiac magnetic resonance imaging Eur. Heart J., October 2, 2008; 29(20): 2544 - 2551. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Cury, K. Nieman, M. D. Shapiro, J. Butler, C. H. Nomura, M. Ferencik, U. Hoffmann, S. Abbara, D. S. Jassal, T. Yasuda, et al. Comprehensive Assessment of Myocardial Perfusion Defects, Regional Wall Motion, and Left Ventricular Function by Using 64-Section Multidetector CT Radiology, August 1, 2008; 248(2): 466 - 475. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nieman, M. D. Shapiro, M. Ferencik, C. H. Nomura, S. Abbara, U. Hoffmann, H. K. Gold, I.-K. Jang, T. J. Brady, and R. C. Cury Reperfused Myocardial Infarction: Contrast-enhanced 64-Section CT in Comparison to MR Imaging Radiology, April 1, 2008; 247(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Gottlieb and J. A.C. Lima Screening High-Risk Patients With Computed Tomography Angiography Circulation, March 11, 2008; 117(10): 1318 - 1332. [Full Text] [PDF]
|
|
|
|
|
|
J. A.C. Lima Another Step Forward in CT Angiography. J. Am. Coll. Cardiol. Img., March 1, 2008; 1(2): 187 - 189. [Full Text] [PDF]
|
|
|
|
|
|
S. Schroeder, S. Achenbach, F. Bengel, C. Burgstahler, F. Cademartiri, P. de Feyter, R. George, P. Kaufmann, A. F. Kopp, J. Knuuti, et al. Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology Eur. Heart J., February 2, 2008; 29(4): 531 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sato, M. Hiroe, T. Nozato, H. Hikita, Y. Ito, H. Ohigashi, M. Tamura, A. Takahashi, M. Isobe, and K. Aonuma Early validation study of 64-slice multidetector computed tomography for the assessment of myocardial viability and the prediction of left ventricular remodelling after acute myocardial infarction Eur. Heart J., February 2, 2008; 29(4): 490 - 498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Dickfeld, P. Lei, V. Dilsizian, J. Jeudy, J. Dong, A. Voudouris, R. Peters, M. Saba, R. Shekhar, and S. Shorofsky Integration of three-dimensional scar maps for ventricular tachycardia ablation with positron emission tomography-computed tomography. J. Am. Coll. Cardiol. Img., January 1, 2008; 1(1): 73 - 82. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Tops, S. C. Krishnan, J. D. Schuijf, M. J. Schalij, and J. J. Bax Noncoronary applications of cardiac multidetector row computed tomography. J. Am. Coll. Cardiol. Img., January 1, 2008; 1(1): 94 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Burgstahler and S. Schroeder Magnetic resonance imaging versus computed tomography for the detection of coronary stenosis: do we really have to focus on "stenoses"? Heart, November 1, 2007; 93(11): 1322 - 1324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.-C. Pouleur, J.-B. le Polain de Waroux, A. Pasquet, J.-L. J. Vanoverschelde, and B. L. Gerber Aortic Valve Area Assessment: Multidetector CT Compared with Cine MR Imaging and Transthoracic and Transesophageal Echocardiography Radiology, September 1, 2007; 244(3): 745 - 754. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Lessick, R. Dragu, D. Mutlak, S. Rispler, R. Beyar, D. Litmanovich, A. Engel, Y. Agmon, M. Kapeliovich, H. Hammerman, et al. Is Functional Improvement after Myocardial Infarction Predicted with Myocardial Enhancement Patterns at Multidetector CT? Radiology, September 1, 2007; 244(3): 736 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Nahrendorf, C. Badea, L. W. Hedlund, J.-L. Figueiredo, D. E. Sosnovik, G. A. Johnson, and R. Weissleder High-resolution imaging of murine myocardial infarction with delayed-enhancement cine micro-CT Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H3172 - H3178. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A.C. Lima and J. Hare Visualizing the Coronaries in Patients Presenting With Heart Failure of Unknown Etiology J. Am. Coll. Cardiol., May 22, 2007; 49(20): 2051 - 2052. [Full Text] [PDF]
|
|
|
|
|
|
A. A. Shiozaki, T. S. Garcia Santos, E. Artega, and C. E. Rochitte Myocardial Delayed Enhancement by Computed Tomography in Hypertrophic Cardiomyopathy Circulation, May 1, 2007; 115(17): e430 - e431. [Full Text] [PDF]
|
|
|
|
|
|
M. Habis, A. Capderou, S. Ghostine, B. Daoud, C. Caussin, J.-Y. Riou, P. Brenot, C. Y. Angel, B. Lancelin, and J.-F. Paul Acute Myocardial Infarction Early Viability Assessment by 64-Slice Computed Tomography Immediately After Coronary Angiography: Comparison With Low-Dose Dobutamine Echocardiography J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1178 - 1185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Di Carli and R. Hachamovitch New Technology for Noninvasive Evaluation of Coronary Artery Disease Circulation, March 20, 2007; 115(11): 1464 - 1480. [Full Text] [PDF]
|
|