Identification and viability assessment of infarcted myocardium with late enhancement multidetector computed tomography: Comparison with thallium single photon emission computed tomography and echocardiography

Kuan Rau Chiou, Chun Peng Liu, Nan Jing Peng, Wei Chun Huang, Shih Hung Hsiao, Yi Luan Huang, Kuen Huang Chen, Ming Ting Wu

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Recent studies revealed that multidetector computed tomography late enhancement (MDCT-LE) is a reliable technique for detecting necrotic and scarred myocardial tissue. The aims of the study were to identify infarcted myocardium using MDCT-LE protocol in patients after myocardial infarction (MI) and assess viability in resting wall motion abnormalities. Methods: One hundred one patients with previous MI (62 ± 13 years, 1-6 months after MI) underwent MDCT-LE (15 minutes after contrast medium administration), rest-redistribution thallium single photon emission computed tomography (Tl-SPECT), and dobutamine echocardiography (DbE). In a 17-segment model, infarcted myocardium detected by MDCT-LE was categorized as none, 1%-25%, 26%-50%, 51%-75%, or >75% segmental extent and was compared with decreased uptake of Tl-SPECT and contractile function by DbE on per patient and segmental basis in a blinded fashion. Results: By per patient analysis, MDCT-LE identified the presence of infarcted myocardium in 97 patients (96%), and Tl-SPECT decreased uptake in 88 patients (87%), (P = .02). By per segment analysis, the concordance for detecting infarcted myocardium was good (κ value = 0.792). In segments with resting wall motion abnormalities (N = 486), there was moderate concordance in assessing viability (κ value between MDCT and Tl-SPECT = 0.555, MDCT and DbE = 0.498, Tl-SPECT and DbE = 0.478) with predefined MDCT-LE threshold of 50% segmental extent. Among segments with MDCT-LE >75% segmental extent, the proportion designated nonviable by Tl-SPECT and DbE reached 87.8% and 92.2%, respectively. Conclusions: Multidetector computed tomography late enhancement is accurate in identifying the presence and extent of infarcted myocardium. Its segmental extent has good correlation with the magnitude of thallium decreased uptake and can predict contractile reserve. Multidetector computed tomography late enhancement can be an alternative to assess viability.

Original languageEnglish
Pages (from-to)738-745
Number of pages8
JournalAmerican Heart Journal
Volume155
Issue number4
DOIs
Publication statusPublished - Apr 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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