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Updated: Jun 2, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI

Robert Goetti1, Gudrun Feuchtner, Paul Stolzmann

  • 1Department of Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.

European Radiology
|May 17, 2011
PubMed

Insights

High-pitch delayed enhancement CT accurately assesses myocardial viability compared to MRI. This CT method offers a low radiation dose for evaluating heart scar tissue in patients with coronary artery disease.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Assessing myocardial viability is crucial for managing patients with coronary artery disease.
  • Magnetic resonance imaging (MRI) is the gold standard for myocardial viability assessment.
  • Delayed enhancement (DE) CT offers a potential alternative imaging modality.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of high-pitch delayed enhancement (DE) CT for assessing myocardial viability.
  • To compare DE CT findings with MRI, the established reference standard.
  • To determine the accuracy of DE CT in identifying non-viable myocardial segments.

Main Methods:

  • Twenty-four patients with coronary artery disease underwent DE imaging using a 128-slice dual-source CT scanner and 1.5 T MRI.
  • Two independent observers assessed DE transmurality, signal intensity/attenuation, and image noise.
  • Contrast-to-noise ratios (CNR) were calculated for both CT and MRI.

Main Results:

  • DE CT demonstrated high accuracy (94.4% per segment, 91.7% per patient) for diagnosing non-viable myocardium.
  • Sensitivity and specificity for non-viability were 60.7% and 96.8% per segment, respectively.
  • MRI showed significantly higher CNR and lower image noise compared to DE CT, which delivered a low radiation dose (0.89 ± 0.07 mSv).

Conclusions:

  • High-pitch DE CT is a viable tool for myocardial viability assessment in patients with coronary artery disease.
  • DE CT provides good diagnostic accuracy comparable to MRI at a significantly lower radiation dose.
  • While DE CT has limitations in CNR and noise compared to MRI, its accuracy and low radiation dose make it a valuable clinical option.
Abstract

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