Noncontrast Myocardial Characterization in Acute Myocardial Infarction Using Electron Density Imaging.

Autor:	Rodriguez-Granillo GA; Department of Cardiovascular Imaging., Cirio J; Stroke Unit., Vila JF; Stroke Unit., Langzam E; Philips Healthcare, CT Clinical Science, Buenos Aires, Argentina., Ivanc T; Philips Healthcare, CT Clinical Science, Buenos Aires, Argentina., Fontana L; Department of Cardiovascular Imaging., Descalzo A; Department of Interventional Cardiology., Rubilar B; Department of Interventional Cardiology., Lylyk P; Department of Interventional Neuroradiology, Instituto Medico ENERI, Clinica La Sagrada Familia.
Jazyk:	angličtina
Zdroj:	Journal of thoracic imaging [J Thorac Imaging] 2024 May 01; Vol. 39 (3), pp. 173-177. Date of Electronic Publication: 2023 Sep 27.
DOI:	10.1097/RTI.0000000000000749
Abstrakt:	Purpose: Spectral computed tomography (CT) enables improved tissue characterization, although virtually all research has focused on contrast-enhanced examinations. We hypothesized that changes in myocardial tissue related to acute myocardial infarction (AMI) might potentially be identified without the need for contrast administration using electron density (ED) imaging. Patients and Methods: This retrospective observational study involved a small series (n = 15) of patients admitted to our institution with a first AMI without signs of hemodynamic instability and identification of a culprit vessel with invasive coronary angiography during the same admission, who also underwent a noncontrast, low-dose chest CT using a dual-layer spectral CT scanner. Images were assessed in search of dark areas with low density on ED imaging, and the mean percentage ED relative to water (%EDW) was calculated. Results: Using a qualitative approach, ED assessment enabled the identification of 11/15 (73%) affected coronary territories, with a sensitivity of 73% (95% CI: 45; 92%) and a specificity of 87% (95% CI: 69; 96%). AMI segments showed significantly lower ED values than the remote myocardium (103.8 ± 0.8 vs 104.3 ± 0.6 %EDW, P < 0.0001), and a threshold below 103.9 %EDW had a sensitivity of 66% and specificity of 79% for the identification of AMI. In a control group of patients without a history of cardiovascular disease, none had areas with focal reduction of ED following the shape of the myocardial wall. Conclusions: In our preliminary series, ED imaging showed the potential to enable the identification of myocardial tissue changes related to AMI without iodinated contrast requirement. Competing Interests: E.L. and T.I. are employees of Philips Healthcare. G.A.R.-G. is a consultant of Sofinnova Partners and the coprincipal investigator of MultiplAI Healthcare. P.L. is consultant of Philips Healthcare. The remaining authors declare no conflict of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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