Abstract:
OBJECTIVES:We sought to compare contrast-enhanced magnetic resonance imaging (ceMRI) with nuclear metabolic imaging for the assessment of myocardial viability in patients with chronic ischemic heart disease and left ventricular (LV) dysfunction. BACKGROUND:Contrast-enhanced MRI has been shown to identify scar tissue in ischemically damaged myocardium. METHODS:Twenty-six patients with chronic coronary artery disease and LV dysfunction (mean ejection fraction 31 +/- 11%) underwent (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET), technetium-99m tetrofosmin single-photon emission computed tomography (SPECT), and ceMRI. In a 17-segment model, the segmental extent of hyperenhancement (SEH) by ceMRI, defined as the relative amount of contrast-enhanced tissue per myocardial segment, was compared with segmental FDG and tetrofosmin uptake by PET and SPECT. RESULTS:In severely dysfunctional segments (n = 165), SEH was 9 +/- 14%, 33 +/- 25% (p < 0.05), and 80 +/- 23% (p < 0.05) in segments with normal metabolism/perfusion, metabolism/perfusion mismatch, and matched defects, respectively. Segmental glucose uptake by PET was inversely correlated to SEH (r = -0.86, p < 0.001). By receiver operator characteristic curve analysis, the area under the curve was 0.95 for the differentiation between viable and non-viable segments. At a cutoff value of 37%, SEH optimally differentiated viable from non-viable segments defined by PET. Using this threshold, the sensitivity and specificity of ceMRI to detect non-viable myocardium as defined by PET were 96% and 84%, respectively. CONCLUSIONS:Contrast-enhanced MRI allows assessment of myocardial viability with a high accuracy, compared with FDG-PET, in patients with chronic ischemic heart disease and LV dysfunction.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Kühl HP,Beek AM,van der Weerdt AP,Hofman MB,Visser CA,Lammertsma AA,Heussen N,Visser FC,van Rossum ACdoi
10.1016/s0735-1097(03)00158-xsubject
Has Abstractpub_date
2003-04-16 00:00:00pages
1341-8issue
8eissn
0735-1097issn
1558-3597pii
S073510970300158Xjournal_volume
41pub_type
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