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%, kappa=0.54, P<0.001) and late hyperenhanced regions (82%, kappa=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.
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%, kappa=0.54, P<0.001) and late hyperenhanced regions (82%, kappa=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 infarctedrabbit 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 gadoliniumDPTA, 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.
Authors: E di Cesare; I Carbone; A Carriero; M Centonze; F De Cobelli; R De Rosa; P Di Renzi; A Esposito; R Faletti; R Fattori; M Francone; A Giovagnoni; L La Grutta; G Ligabue; L Lovato; R Marano; M Midiri; L Natale; A Romagnoli; V Russo; F Sardanelli; F Cademartiri Journal: Radiol Med Date: 2012-04-01 Impact factor: 3.469
Authors: Shuning Huang; Howard H Chen; Hushan Yuan; Guangping Dai; Daniel T Schuhle; Choukri Mekkaoui; Soeun Ngoy; Ronglih Liao; Peter Caravan; Lee Josephson; David E Sosnovik Journal: Circ Cardiovasc Imaging Date: 2011-08-11 Impact factor: 7.792