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Updated: Aug 17, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Usefulness of myocardial parametric imaging to evaluate myocardial viability in experimental and in clinical studies
G Korosoglou1, A Hansen, R Bekeredjian
1Department of Cardiology, University of Heidelberg, Heidelberg, Germany. Grigorios_Korosoglou@med.uni-heidelberg.de
Objective:
To evaluate whether myocardial parametric imaging (MPI) is superior to visual assessment for the evaluation of myocardial viability.
Methods And Results:
Myocardial contrast echocardiography (MCE) was assessed in 11 pigs before, during, and after left anterior descending coronary artery occlusion and in 32 patients with ischaemic heart disease by using intravenous SonoVue administration. In experimental studies perfusion defect area assessment by MPI was compared with visually guided perfusion defect planimetry. Histological assessment of necrotic tissue was the standard reference. In clinical studies viability was assessed on a segmental level by (1) visual analysis of myocardial opacification; (2) quantitative estimation of myocardial blood flow in regions of interest; and (3) MPI. Functional recovery between three and six months after revascularisation was the standard reference. In experimental studies, compared with visually guided perfusion defect planimetry, planimetric assessment of infarct size by MPI correlated more significantly with histology (r2 = 0.92 versus r2 = 0.56) and had a lower intraobserver variability (4% v 15%, p < 0.05). In clinical studies, MPI had higher specificity (66% v 43%, p < 0.05) than visual MCE and good accuracy (81%) for viability detection. It was less time consuming (3.4 (1.6) v 9.2 (2.4) minutes per image, p < 0.05) than quantitative blood flow estimation by regions of interest and increased the agreement between observers interpreting myocardial perfusion (kappa = 0.87 v kappa = 0.75, p < 0.05).
Conclusion:
MPI is useful for the evaluation of myocardial viability both in animals and in patients. It is less time consuming than quantification analysis by regions of interest and less observer dependent than visual analysis. Thus, strategies incorporating this technique may be valuable for the evaluation of myocardial viability in clinical routine.
Insights
Myocardial parametric imaging (MPI) offers a more accurate and efficient method for assessing myocardial viability compared to visual evaluation. This technique improves diagnostic consistency and reduces assessment time in both animal models and human patients.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Assessing myocardial viability is crucial for managing ischemic heart disease.
- Traditional visual assessment of myocardial perfusion has limitations in accuracy and observer variability.
Purpose of the Study:
- To compare the efficacy of myocardial parametric imaging (MPI) against visual assessment for evaluating myocardial viability.
- To determine if MPI is superior to visual interpretation in accuracy, efficiency, and inter-observer agreement.
Main Methods:
- Myocardial contrast echocardiography (MCE) with SonoVue was used in 11 pigs and 32 patients.
- Experimental studies compared MPI with visual planimetry against histological infarct size.
- Clinical studies assessed viability using visual analysis, quantitative blood flow, and MPI, with functional recovery as the reference standard.
Main Results:
- MPI demonstrated higher correlation with histology (r2=0.92) and lower intraobserver variability (4%) in experimental studies.
- In clinical studies, MPI showed higher specificity (66%) and good accuracy (81%) for viability detection.
- MPI was significantly faster (3.4 min/image) and improved inter-observer agreement (kappa=0.87) compared to visual assessment.
Conclusions:
- Myocardial parametric imaging (MPI) is a valuable tool for assessing myocardial viability in both animal models and human patients.
- MPI is more time-efficient and less observer-dependent than traditional quantification and visual analysis.
- Incorporating MPI into clinical practice may enhance the routine evaluation of myocardial viability.
