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Published on: February 16, 2016
COVID-19-related cardiomyopathy: Can dual-energy computed tomography be a diagnostic tool?
Fahri Aydin1, Mecit Kantarci1, Sonay Aydın2
1Department of Radiology, Ataturk University, Erzurum 25000, Turkey.
Insights
Dual energy computed tomography (DECT) can identify myocardial perfusion deficits in COVID-19 patients, even without coronary artery occlusion. This imaging technique shows high interrater agreement for detecting these cardiac issues.
Area of Science:
- Cardiology
- Radiology
- Infectious Diseases
Background:
- Limited research exists on dual energy computed tomography (DECT) for evaluating cardiac complications in COVID-19.
- Myocardial perfusion deficits are observed in COVID-19 patients, independent of coronary artery occlusion.
- DECT demonstrates potential for visualizing these perfusion deficits with high interrater agreement.
Purpose of the Study:
- To assess lung perfusion alterations in COVID-19 patients using DECT.
- To investigate the role of DECT in detecting cardiac abnormalities in COVID-19 patients.
- To evaluate DECT's efficacy in identifying potentially fatal myocardial issues associated with COVID-19.
Main Methods:
- Two independent examiners analyzed CT images using the 17-segment model for left ventricular myocardium segmentation.
- Coronary arteries and branches were assessed for intraluminal diseases and abnormalities.
- Perfusion deficiencies were identified on DECT iodine maps following segment-by-segment analysis.
Main Results:
- The study included 87 patients (42 COVID-19 positive, 45 controls).
- Perfusion deficits were detected in 66.6% of COVID-19 patients, with various anatomical locations (subepicardial, intramyocardial, transmural).
- Control patients showed normal iodine distribution; no subendocardial involvement was observed.
Conclusions:
- Myocardial perfusion deficits occur in COVID-19 patients, even without significant coronary artery occlusion.
- DECT effectively visualizes these perfusion deficits with excellent interrater agreement.
- Perfusion deficit presence correlates positively with D-dimer levels in COVID-19 patients.
Background:
No study on dual energy computed tomography (DECT) has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019 (COVID-19) patients. Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion, and these deficits can be shown via DECT with a perfect interrater agreement.
Aim:
To assess lung perfusion alterations in COVID-19 patients. To our knowledge, no study using DECT has been performed to evaluate possibly fatal cardiac/ myocardial problems in COVID-19 patients. The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.
Methods:
Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association's classification of the segmentation of the left ventricular myocardium. Additionally, intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated. Following segment-by-segment analysis, perfusion deficiencies identified on the iodine map pictures on DECT were identified.
Results:
The study enrolled a total of 87 patients. Forty-two of these individuals were classified as COVID-19 positive, and 45 were classified as controls. Perfusion deficits were identified in 66.6% (n = 30) of the cases. All control patients had a normal iodine distribution map. Perfusion deficits were found on DECT iodine map images with subepicardial (n = 12, 40%), intramyocardial (n = 8, 26.6%), or transmural (n = 10, 33.3%) anatomical locations within the left ventricular wall. There was no subendocardial involvement in any of the patients.
Conclusion:
Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion. These deficits can be shown via DECT with a perfect interrater agreement. Additionally, the presence of perfusion deficit is positively correlated with D-dimer levels.
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