Assessment of myocardial perfusion and viability from routine contrast-enhanced 16-detector-row computed tomography of the heart: preliminary results

To assess the diagnostic accuracy of 16-detector-row computed tomography (16DCT) of the heart in the assessment of myocardial perfusion and viability in comparison to stress perfusion magnetic resonance imaging (SP-MRI) and delayed-enhancement magnetic resonance imaging (DE-MRI). A number of 30 pati...

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Bibliographic Details
Published in:European radiology 2005-05, Vol.15 (5), p.864-871
Main Authors: Nikolaou, Konstantin, Sanz, Javier, Poon, Michael, Wintersperger, Bernd J, Ohnesorge, Bernd, Rius, Teresa, Fayad, Zahi A, Reiser, Maximilian F, Becker, Christoph R
Format: Article
Language:English
Subjects:
Accuracy
Adult
Aged
Aged, 80 and over
Computed tomography
Contrast Media
Coronary Circulation
Defects
Female
Gadolinium DTPA
Heart
Heart attacks
Humans
Image contrast
Image enhancement
Image Processing, Computer-Assisted
Ischemia
Magnetic Resonance Imaging
Male
Medical imaging
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - pathology
Myocardium
Perfusion
Sensitivity analysis
Sensitivity and Specificity
Sensors
Tomography
Tomography, X-Ray Computed - methods
Volumetric analysis
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Summary:To assess the diagnostic accuracy of 16-detector-row computed tomography (16DCT) of the heart in the assessment of myocardial perfusion and viability in comparison to stress perfusion magnetic resonance imaging (SP-MRI) and delayed-enhancement magnetic resonance imaging (DE-MRI). A number of 30 patients underwent both 16DCT and MRI of the heart. Contrast-enhanced 16DCT data sets were reviewed for areas of myocardium with reduced attenuation. Both CT and MRI data were examined by independent reviewers for the presence of myocardial perfusion defects or myocardial infarctions (MI). Volumetric analysis of the hypoperfusion areas in CT and the infarct sizes in DE-MRI were performed. According to MRI, myocardial infarctions were detected in 11 of 30 cases, and perfusion defects not corresponding to an MI were detected in six of 30 patients. CTA was able to detect ten of 11 MI correctly (sensitivity 91%, specificity 79%, accuracy 83%), and detected three of six hypoperfusions correctly (sensitivity 50%, specificity 92%, accuracy 79%). Assessing the volume of perfusion defects correlating to history of MI on the CT images, a systematic underestimation of the true infarct size as compared to the results of DE-MRI was found (P
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-005-2672-6