Evaluation of Reperfused Myocardial Infarction by Low-Dose Multidetector Computed Tomography Using Prospective Electrocardiography (ECG)- Triggering: Comparison with Magnetic Resonance Imaging
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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.
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.
참고문헌 (21)
- Gutberlet M, "Myocardial viability assessment in patients with highly impaired left ventricular function: comparison of delayed enhancement, dobutamine stress MRI, end-diastolic wall thickness, and TI201-SPECT with functional recovery after revascularization", Eur Radiol, 15, pp.872~880 (2005)
- Lardo AC, "Contrast-enhanced multidetector computed tomography viability imaging after myocardial infarction: characterization of myocyte death, microvascular obstruction, and chronic scar", Circulation, 113, pp.394~404 (2006)
- Kühl HP, "Myocardial viability: rapid assessment with delayed contrast-enhanced MR imaging with three-dimensional inversion-recovery prepared pulse sequence", Radiology, 230, pp.576~582 (2004)
- Kim RJ, "The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction", N Engl J Med, 343, pp.1445~1453 (2000)
- Nieman K, "Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography", Circulation, 106, pp.2051~2054 (2002)
- Mollet NR, "High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography", Circulation, 112, pp.2318~2323 (2005)
- Achenbach S, "Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT", Circulation, 102, pp.2823~2828 (2000)
- Chiou KR, "Identification and viability assessment of infarcted myocardium with late enhancement multidetector computed tomography:comparison with thallium single photon emission computed tomography and echocardiography", Am Heart J, 155, pp.738~745 (2008)
- Sato A, "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, 29, pp.490~498 (2008)
- Nieman K, "Reperfused myocardial infarction: contrastenhanced 64-Section CT in comparison to MR imaging", Radiology, 247, pp.49~56 (2008)
- Husmann L, "Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating", Eur Heart J, 29, pp.191~197 (2008)
- Shuman WP, "Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose", Radiology, 248, pp.431~437 (2008)
- Bland JM, "Statistical methods for assessing agreement between two methods of clinical measurement", Lancet, 1, pp.307~310 (1986)
- Büecker A, "A feasibility study of contrast enhancement of acute myocardial infarction in multislice computed tomography:comparison with magnetic resonance imaging and gross morphology in pigs", Invest Radiol, 40, pp.700~704 (2005)
- Brodoefel H, "Assessment of myocardial viability in a reperfused porcine model: evaluation of different MSCT contrast protocols in acute and subacute infarct stages in comparison with MRI", J Comput Assist Tomogr, 31, pp.290~298 (2007)
- Baks T, "Assessment of acute reperfused myocardial infarction with delayed enhancement 64-MDCT", Am J Roentgenol, 188, pp.W135~137 (2007)
- Mahnken AH, "Assessment of myocardial viability in reperfused acute myocardial infarction using 16-slice computed tomography in comparison to magnetic resonance imaging", J Am Coll Cardiol, 45, pp.2042~2047 (2005)
- Trabold T, "Estimation of radiation exposure in 16-detector row computed tomography of the heart with retrospective ECGgating", Rofo, 175, pp.1051~1055 (2003)
- Hirai N, "Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose", Radiology, 248, pp.424~430 (2008)
- Giesler T, "Noninvasive visualization of coronary arteries using contrast-enhanced multidetector CT: influence of heart rate on image quality and stenosis detection", AJR Am J Roentgenol, 179, pp.911~916 (2002)
- Kopp AF, "Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization of the image reconstruction window", Radiology, 221, pp.683~688 (2001)