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Updated: Mar 16, 2026
3D Whole-heart Myocardial Tissue Analysis
Published on: April 12, 2017
Three-dimensional maximum principal strain using cardiac computed tomography for identification of myocardial
Yuki Tanabe1, Teruhito Kido2, Akira Kurata2
1Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime, 791-0295, Japan. yuki.tanabe.0225@gmail.com.
Insights
Three-dimensional maximum principal strain (MP-strain) from cardiac computed tomography (CT) shows high accuracy for detecting myocardial infarction (MI). This CT-derived MP-strain offers incremental value beyond coronary CT angiography for MI diagnosis.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Radiology
Background:
- Myocardial infarction (MI) diagnosis relies on imaging techniques.
- Assessing regional cardiac function and myocardial viability is crucial for MI management.
- Current methods may have limitations in accurately characterizing infarct extent and function.
Purpose of the Study:
- To assess the feasibility of using three-dimensional (3D) maximum principal strain (MP-strain) from cardiac computed tomography (CT) for detecting MI.
- To compare the diagnostic performance of CT-derived MP-strain with traditional metrics like percent systolic wall thickening (%SWT) from cardiac MRI.
Main Methods:
- Retrospective analysis of 43 patients who underwent both cardiac CT and MRI.
- Peak CT MP-strain was measured using a 16-segment model with voxel tracking.
- Segments were classified based on late gadolinium enhancement (LGE) to define infarcted and border zones.
- Diagnostic performance was evaluated using receiver-operating characteristic (ROC) curve analysis.
Main Results:
- CT MP-strain demonstrated high sensitivity (81%) and specificity (86%) for MI detection.
- The area under the ROC curve for MP-strain (0.90) was significantly superior to %SWT (0.80).
- MP-strain showed potential for tissue characterization, aiding in the assessment of myocardium affected by MI.
Conclusions:
- CT-derived MP-strain is a feasible and accurate method for detecting myocardial infarction.
- MP-strain offers incremental diagnostic value when combined with coronary CT angiography.
- This technique may enhance the characterization of myocardial tissue, complementing LGE-MRI findings.
Objectives:
To evaluate the feasibility of three-dimensional (3D) maximum principal strain (MP-strain) derived from cardiac computed tomography (CT) for detecting myocardial infarction (MI).
Methods:
Forty-three patients who underwent cardiac CT and magnetic resonance imaging (MRI) were retrospectively selected. Using the voxel tracking of motion coherence algorithm, the peak CT MP-strain was measured using the 16-segment model. With the trans-mural extent of late gadolinium enhancement (LGE) and the distance from MI, all segments were classified into four groups (infarcted, border, adjacent, and remote segments); infarcted and border segments were defined as MI with LGE positive. Diagnostic performance of MP-strain for detecting MI was compared with per cent systolic wall thickening (%SWT) assessed by MRI using receiver-operating characteristic curve analysis at a segment level.
Results:
Of 672 segments excluding16 segments influenced by artefacts, 193 were diagnosed as MI. Sensitivity and specificity of peak MP-strain to identify MI were 81 % [95 % confidence interval (95 % CI): 74-88 %] and 86 % (81-92 %) compared with %SWT: 76 % (60-95 %) and 68 % (48-84 %), respectively. The area under the curve of peak MP-strain was superior to %SWT [0.90 (0.87-0.93) vs. 0.80 (0.76-0.83), p < 0.05].
Conclusions:
CT MP-strain has a potential to provide incremental value to coronary CT angiography for detecting MI.
Key Points:
• CT MP-strain allows for three-dimensional assessment of regional cardiac function. • CT-MP strain has high diagnostic accuracy for detecting myocardial infarction. • CT-MP strain may assist in tissue characterisation of myocardium assessed by LGE-MRI. • CT-MP strain provides incremental values to coronary CTA for detecting myocardial infarction.
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