OBJECTIVES: Cardiac C-arm computed tomography (CT) uses a standard C-arm fluoroscopy system rotating around the patient to provide CT-like images during interventional procedures without moving the patient to a conventional CT scanner. We hypothesized that C-arm CT can be used to visualize and quantify the size of perfusion defects and late enhancement resulting from a myocardial infarction (MI) using contrast-enhanced techniques similar to previous CT and magnetic resonance imaging studies. MATERIALS AND METHODS: A balloon occlusion followed by reperfusion in a coronary artery was used to study acute and subacute MI in 12 swine. Electrocardiographically gated C-arm CT images were acquired the day of infarct creation (n = 6) or 4 weeks after infarct creation (n = 6). The images were acquired immediately after contrast injection, then at 1 minute, and every 5 minutes up to 30 minutes with no additional contrast. The volume of the infarct as measured on C-arm CT was compared against pathology. RESULTS: The volume of acute MI, visualized as a combined region of hyperenhancement with a hypoenhanced core, correlated well with pathologic staining (concordance correlation, 0.89; P < 0.0001; mean [SD] difference, 0.67 [2.98]cm3). The volume of subacute MI, visualized as a region of hyperenhancement, correlated well with pathologic staining at imaging times 5 to 15 minutes after contrast injection (concordance correlation, 0.82; P < 0.001; mean difference, -0.64 [1.94]cm3). CONCLUSIONS: C-arm CT visualization of acute and subacute MI is possible in a porcine model, but improvement in the imaging technique is important before clinical use. Visualization of MI in the catheterization laboratory may be possible and could provide 3-dimensional images for guidance during interventional procedures.
OBJECTIVES: Cardiac C-arm computed tomography (CT) uses a standard C-arm fluoroscopy system rotating around the patient to provide CT-like images during interventional procedures without moving the patient to a conventional CT scanner. We hypothesized that C-arm CT can be used to visualize and quantify the size of perfusion defects and late enhancement resulting from a myocardial infarction (MI) using contrast-enhanced techniques similar to previous CT and magnetic resonance imaging studies. MATERIALS AND METHODS: A balloon occlusion followed by reperfusion in a coronary artery was used to study acute and subacute MI in 12 swine. Electrocardiographically gated C-arm CT images were acquired the day of infarct creation (n = 6) or 4 weeks after infarct creation (n = 6). The images were acquired immediately after contrast injection, then at 1 minute, and every 5 minutes up to 30 minutes with no additional contrast. The volume of the infarct as measured on C-arm CT was compared against pathology. RESULTS: The volume of acute MI, visualized as a combined region of hyperenhancement with a hypoenhanced core, correlated well with pathologic staining (concordance correlation, 0.89; P < 0.0001; mean [SD] difference, 0.67 [2.98]cm3). The volume of subacute MI, visualized as a region of hyperenhancement, correlated well with pathologic staining at imaging times 5 to 15 minutes after contrast injection (concordance correlation, 0.82; P < 0.001; mean difference, -0.64 [1.94]cm3). CONCLUSIONS: C-arm CT visualization of acute and subacute MI is possible in a porcine model, but improvement in the imaging technique is important before clinical use. Visualization of MI in the catheterization laboratory may be possible and could provide 3-dimensional images for guidance during interventional procedures.
Authors: Albert C Lardo; Marco A S Cordeiro; Caterina Silva; Luciano C Amado; Richard T George; Anastasios P Saliaris; Karl H Schuleri; Veronica R Fernandes; Menekhem Zviman; Saman Nazarian; Henry R Halperin; Katherine C Wu; Joshua M Hare; Joao A C Lima Journal: Circulation Date: 2006-01-24 Impact factor: 29.690
Authors: H Brodoefel; B Klumpp; A Reimann; M Fenchel; M Heuschmid; S Miller; S Schroeder; C Claussen; A M Scheule; A F Kopp Journal: Eur J Radiol Date: 2006-12-21 Impact factor: 3.528
Authors: R J Kim; D S Fieno; T B Parrish; K Harris; E L Chen; O Simonetti; J Bundy; J P Finn; F J Klocke; R M Judd Journal: Circulation Date: 1999-11-09 Impact factor: 29.690
Authors: K Soejima; M Suzuki; W H Maisel; C B Brunckhorst; E Delacretaz; L Blier; S Tung; H Khan; W G Stevenson Journal: Circulation Date: 2001-08-07 Impact factor: 29.690
Authors: B P Barnett; D L Kraitchman; C Lauzon; C A Magee; P Walczak; W D Gilson; A Arepally; J W M Bulte Journal: Mol Pharm Date: 2006 Sep-Oct Impact factor: 4.939
Authors: K C Wu; R J Kim; D A Bluemke; C E Rochitte; E A Zerhouni; L C Becker; J A Lima Journal: J Am Coll Cardiol Date: 1998-11-15 Impact factor: 24.094