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European Radiology
Published in: European Radiology 10/2011

01-10-2011 | Cardiac

Delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI

Authors: Robert Goetti, Gudrun Feuchtner, Paul Stolzmann, Olivio F. Donati, Monika Wieser, André Plass, Thomas Frauenfelder, Sebastian Leschka, Hatem Alkadhi

Published in: European Radiology | Issue 10/2011

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Abstract

Objectives

To evaluate the accuracy of high-pitch delayed enhancement (DE) CT for the assessment of myocardial viability with MRI as the reference standard.

Methods

Twenty-four patients (mean age 66.9 ± 9.2 years) with coronary artery disease underwent DE imaging with 128-slice dual-source CT (prospective electrocardiography (ECG)-triggering) and MRI at 1.5 T. Two observers assessed DE transmurality per segment, and measured signal intensity (MRI) or attenuation (CT) in infarcted and healthy myocardium and noise in the left ventricular blood pool for calculating contrast-to-noise ratios (CNR).

Results

75/408 (18.4%) segments in 18/24 patients (75.0%) showed DE in MRI, of which 28 segments in 10/24 (41.7%) patients were non-viable (scar tissue transmurality >50%). Sensitivity, specificity and accuracy of CT for diagnosis of non-viability were 60.7%, 96.8% and 94.4% per segment, and 90.0%, 92.9% and 91.7% per patient. CNR was significantly higher in MR (7.4 ± 3.0 vs. 4.6 ± 1.5; p = 0.018), and image noise significantly lower (11.6 ± 5.7 vs.15.0 ± 4.5; p = 0.019). Radiation dose of DECT was 0.89 ± 0.07 mSv.

Conclusions

CTDE imaging in the high-pitch mode enables myocardial viability assessment at a low radiation dose and good accuracy compared with MR, although associated with a lower CNR and higher noise.
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Metadata
Title
Delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI
Authors
Robert Goetti
Gudrun Feuchtner
Paul Stolzmann
Olivio F. Donati
Monika Wieser
André Plass
Thomas Frauenfelder
Sebastian Leschka
Hatem Alkadhi
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 10/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2149-8

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