Comprehensive Assessment of Myocardial Perfusion Defects, Regional Wall Motion, and Left Ventricular Function by Using 64-Section Multidetector CT
| Autor: | Ik-Kyung Jang, Cesar Higa Nomura, Tsunehiro Yasuda, Udo Hoffmann, Javed Butler, Ricardo C. Cury, Koen Nieman, Maros Ferencik, Thomas J. Brady, Michael D. Shapiro, Suhny Abbara, Davinder S. Jassal, Herman K. Gold |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Technetium Tc 99m Sestamibi Myocardial Infarction Contrast Media Multidetector ct Sensitivity and Specificity Ventricular Dysfunction Left Triiodobenzoic Acids medicine Humans Radiology Nuclear Medicine and imaging In patient Prospective Studies cardiovascular diseases Wall motion Myocardial infarction Acute mi Retrospective Studies Original Research Tomography Emission-Computed Single-Photon Chi-Square Distribution Ventricular function business.industry Middle Aged medicine.disease Echocardiography cardiovascular system Female Tomography Radiopharmaceuticals Tomography X-Ray Computed Nuclear medicine business Perfusion Biomarkers |
| Zdroj: | Radiology. 248:466-475 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2482071478 |
| Popis: | To evaluate the accuracy of 64-section multidetector computed tomography (CT) for the assessment of perfusion defects (PDs), regional wall motion (RWM), and global left ventricular (LV) function.All myocardial infarction (MI) patients signed informed consent. The IRB approved the study and it was HIPAA-compliant. Cardiac multidetector CT was performed in 102 patients (34 with recent acute MI and 68 without). Multidetector CT images were analyzed for myocardial PD, RWM abnormalities, and LV function. Global LV function and RWM were compared with transthoracic echocardiography (TTE) by using multidetector CT. PD was detected by using multidetector CT and was correlated with cardiac biomarkers and single photon emission CT (SPECT) myocardial perfusion imaging. Multidetector CT diagnosis of acute MI was made on the basis of matching the presence of PD with RWM abnormalities compared with clinical evaluation.Correlation between multidetector CT and TTE for global function (r = 0.68) and RWM (kappa = 0.79) was good. The size of PD on multidetector CT had a moderate correlation against SPECT (r = 0.48, -7% +/- 9). There was good to excellent correlation between cardiac biomarkers and the percentage infarct size by using multidetector CT (r = 0.82 for creatinine phosphokinase, r = 0.76 for creatinine phosphokinase of the muscle band, and r = 0.75 for troponin). For detection of acute MI in patients, multidetector CT sensitivity was 94% (32 of 34) and specificity was 97% (66 of 68). Multidetector CT had an excellent interobserver reliability for ejection fraction quantification (r = 0.83), as compared with TTE (r = 0.68).Patients with acute MI can be identified by using multidetector CT on the basis of RWM abnormalities and PD. |
| Databáze: | OpenAIRE |
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