Abstract:
PURPOSE:To evaluate the accuracy of 64-section multidetector computed tomography (CT) for the assessment of perfusion defects (PDs), regional wall motion (RWM), and global left ventricular (LV) function. MATERIALS AND METHODS:All myocardial infarction (MI) patients signed informed consent. The IRB approved the study and it was HIPAA-compliant. Cardiac multidetector CT was performed in 102 patients (34 with recent acute MI and 68 without). Multidetector CT images were analyzed for myocardial PD, RWM abnormalities, and LV function. Global LV function and RWM were compared with transthoracic echocardiography (TTE) by using multidetector CT. PD was detected by using multidetector CT and was correlated with cardiac biomarkers and single photon emission CT (SPECT) myocardial perfusion imaging. Multidetector CT diagnosis of acute MI was made on the basis of matching the presence of PD with RWM abnormalities compared with clinical evaluation. RESULTS:Correlation between multidetector CT and TTE for global function (r = 0.68) and RWM (kappa = 0.79) was good. The size of PD on multidetector CT had a moderate correlation against SPECT (r = 0.48, -7% +/- 9). There was good to excellent correlation between cardiac biomarkers and the percentage infarct size by using multidetector CT (r = 0.82 for creatinine phosphokinase, r = 0.76 for creatinine phosphokinase of the muscle band, and r = 0.75 for troponin). For detection of acute MI in patients, multidetector CT sensitivity was 94% (32 of 34) and specificity was 97% (66 of 68). Multidetector CT had an excellent interobserver reliability for ejection fraction quantification (r = 0.83), as compared with TTE (r = 0.68). CONCLUSION:Patients with acute MI can be identified by using multidetector CT on the basis of RWM abnormalities and PD.
journal_name
Radiologyjournal_title
Radiologyauthors
Cury RC,Nieman K,Shapiro MD,Butler J,Nomura CH,Ferencik M,Hoffmann U,Abbara S,Jassal DS,Yasuda T,Gold HK,Jang IK,Brady TJdoi
10.1148/radiol.2482071478subject
Has Abstractpub_date
2008-08-01 00:00:00pages
466-75issue
2eissn
0033-8419issn
1527-1315pii
248/2/466journal_volume
248pub_type
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