Τρίτη 13 Φεβρουαρίου 2018

Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction

Abstract

Objective

To evaluate the feasibility of image subtraction in late iodine enhancement CT (LIE-CT) for assessment of myocardial infarction (MI).

Methods

A comprehensive cardiac CT protocol and late gadolinium enhancement MRI (LGE-MRI) was used to assess coronary artery disease in 27 patients. LIE-CT was performed after stress CT perfusion (CTP) and CT angiography. Subtraction LIE-CT was created by subtracting the mask volume of the left ventricle (LV) cavity from the original LIE-CT using CTP dataset. The %MI volume was quantified as the ratio of LIE to entire LV volume, and transmural extent (TME) of LIE was classified as 0%, 1–24%, 25–49%, 50–74% or 75–100%. These results were compared with LGE-MRI using the Spearman rank test, Bland-Altman method and chi-square test.

Results

One hundred twenty-five (29%) of 432 segments were positive on LGE-MRI. Correlation coefficients for original and subtraction LIE-CT to LGE-MRI were 0.79 and 0.85 for %MI volume. Concordances of the 5-point grading scale between original and subtraction LIE-CT with LGE-MRI were 75% and 84% for TME; concordance was significantly improved using the subtraction technique (p <0.05).

Conclusion

Subtraction LIE-CT allowed more accurate assessment of MI extent than the original LIE-CT.

Key Points

Subtraction LIE-CT allows for accurate assessment of the extent of myocardial infarction.

Subtraction LIE-CT shows a close correlation with LGE-MRI in %MI volume.

Subtraction LIE-CT has significantly higher concordance with TME assessment than original LIE-CT.



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