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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Enhancement patterns detected by multidetector computed tomography are associated with microvascular obstruction and

Hiroaki Watabe1, Akira Sato2, Hidetaka Nishina3

  • 1Cardiovascular Division, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.

European Heart Journal
|September 20, 2015
PubMed

Insights

Heterogeneous enhancement on multidetector computed tomography (MDCT) after percutaneous coronary intervention (PCI) can predict microvascular obstruction and left ventricular remodelling in acute myocardial infarction (AMI) patients.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Acute myocardial infarction (AMI) can lead to microvascular obstruction (MVO) and left ventricular (LV) remodelling.
  • Assessing these post-AMI complications is crucial for patient management.
  • Multidetector computed tomography (MDCT) is an imaging modality used in cardiology.

Purpose of the Study:

  • To evaluate the clinical value of myocardial contrast-delayed enhancement (DE) with MDCT.
  • To detect MVO and LV remodelling after AMI.
  • To compare MDCT findings with DE magnetic resonance imaging (MRI).

Main Methods:

  • MDCT with DE was performed in 92 patients post-AMI and successful percutaneous coronary intervention (PCI).
  • DE magnetic resonance imaging (MRI) was used as a reference standard for MVO and LV remodelling.
  • Patients were categorized based on heterogeneous enhancement (HE) patterns on MDCT.

Main Results:

  • Heterogeneous enhancement (HE) and a relative CT density >2.20 were significant predictors of MVO.
  • HE and relative CT density >2.20 demonstrated high positive (93%) and negative (90%) predictive values for MVO.
  • HE was significantly associated with LV remodelling.

Conclusions:

  • MDCT-detected heterogeneous enhancement shortly after primary PCI shows promise.
  • This imaging technique can aid in predicting MVO and LV remodelling in AMI patients.
Abstract

Keywords:
Acute myocardial infarctionDelayed-enhancement magnetic resonance imagingMicrovascular obstructionMultidetector computed tomographyPercutaneous coronary intervention

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