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European Radiology
Published in: European Radiology 8/2015

01-08-2015 | Cardiac

Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study

Authors: Jean-François Deux, Cristian-Ionut Mihalache, François Legou, Thibaud Damy, Julie Mayer, Stéphane Rappeneau, Violaine Planté-Bordeneuve, Alain Luciani, Hicham Kobeiter, Alain Rahmouni

Published in: European Radiology | Issue 8/2015

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Abstract

Objectives

To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT).

Methods

Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNRmyoc), blood pool SNR (SNRblood), contrast-to-noise ratio between blood pool and myocardium (CNRblood-myoc) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated.

Results

Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNRmyoc of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 ± 1.9) and higher on delayed acquisition (7.10 ± 2.7) than control patients (6.1 ± 2.2 and 5.03 ± 1.8, respectively). Myocardial attenuation was higher in CA (121 ± 39 HU) than control patients (81 ± 17 HU) on delayed acquisition. CNRblood-myoc was significantly (p < 0.05) lower in CA (1.51 ± 0.7) than control patients (2.85 ± 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 ± 0.25) than in control patients (−0.56 ± 0.21).

Conclusion

Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA.

Key points

• CT can detect abnormal first-pass and delayed enhancement in cardiac amyloidosis.
• Measurement of relative myocardial enhancement between acquisitions helps to detect cardiac amyloidosis.
• CT may provide useful data to diagnose cardiac amyloidosis.
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Metadata
Title
Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study
Authors
Jean-François Deux
Cristian-Ionut Mihalache
François Legou
Thibaud Damy
Julie Mayer
Stéphane Rappeneau
Violaine Planté-Bordeneuve
Alain Luciani
Hicham Kobeiter
Alain Rahmouni
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3642-2

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