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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions

Gastón A Rodríguez-Granillo1, Miguel A Rosales, Paola Renes

  • 1Department of Cardiovascular Imaging, Otamendi Hospital, Azcuenaga 870 (C1115AAB), Buenos Aires, Argentina. grodriguezgranillo@gmail.com

Journal of Cardiovascular Computed Tomography
|January 12, 2010
PubMed

Insights

Standard noncontrast CT scans, used for coronary artery calcium (CAC) scoring, can identify chronic myocardial infarction (MI). This noninvasive method effectively detects hypoenhancement in heart muscle regions affected by previous MI.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Cardiac CT

Background:

  • Hypoenhanced regions on multidetector CT (MDCT) coronary angiography indicate myocardial hyperperfusion.
  • Chronic myocardial infarction (MI) is characterized by reduced capillary density and increased adipose tissue.

Purpose of the Study:

  • To determine if regional myocardial hypoenhancement, visible on contrast-enhanced MDCT, can be detected using standard noncontrast CT scans typically performed for coronary artery calcium (CAC) scoring.
  • Investigate the utility of noncontrast CT for identifying chronic MI.

Main Methods:

  • Retrospective analysis of consecutive patients with a history of MI who underwent both contrast-enhanced MDCT and noncontrast CT for CAC scoring.
  • Evaluation of 1411 myocardial segments to correlate regional myocardial hypoenhancement on contrast-enhanced CT with hypoattenuated areas on noncontrast CT.

Main Results:

  • Noncontrast CT demonstrated high specificity (100%) and positive predictive value (99% on segment level) for detecting myocardial hypoenhancement.
  • On a per-patient basis, noncontrast CT achieved 66% sensitivity and 100% specificity in identifying myocardial hypoenhancement.
  • On a per-segment basis, sensitivity was 58% and specificity was 100% for noncontrast CT in detecting hypoenhancement.

Conclusions:

  • Standard noncontrast CT acquisitions, commonly used for CAC scoring, can effectively detect chronic myocardial infarction (MI).
  • This approach offers a noninvasive method for identifying myocardial regions affected by previous MI without requiring contrast agents.
Abstract

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