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Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions.
Rodríguez-Granillo, Gastón A Rosales, Miguel A Renes, Paola Diez, Eduardo Pereyra, Jorge Gomez, Estela De Lillo, Gustavo Degrossi, Elina Rodriguez, Alfredo E McFadden, Eugene P
Rodríguez-Granillo, Gastón A
Rosales, Miguel A
Renes, Paola
Diez, Eduardo
Pereyra, Jorge
Gomez, Estela
De Lillo, Gustavo
Degrossi, Elina
Rodriguez, Alfredo E
McFadden, Eugene P
Advisors
Editors
Other Contributors
Date
2012-01-05T14:51:06Z
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adipose Tissue
Aged
Calcinosis
Chronic Disease
Contrast Media
Coronary Angiography
Coronary Circulation
Coronary Vessels
Female
Heart
Humans
Male
Middle Aged
Myocardial Infarction
Myocardial Revascularization
Myocardium
Necrosis
Retrospective Studies
Tomography, X-Ray Computed
Ventricular Function, Left
Aged
Calcinosis
Chronic Disease
Contrast Media
Coronary Angiography
Coronary Circulation
Coronary Vessels
Female
Heart
Humans
Male
Middle Aged
Myocardial Infarction
Myocardial Revascularization
Myocardium
Necrosis
Retrospective Studies
Tomography, X-Ray Computed
Ventricular Function, Left
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
Hypoenhanced regions on multidetector CT (MDCT) coronary angiography correlate with myocardial hyperperfusion. In addition to a limited capillary density, chronic myocardial infarction (MI) commonly contains a considerable amount of adipose tissue.
We explored whether regional myocardial hypoenhancement on contrast-enhanced MDCT could be identified with standard coronary artery calcium (CAC) scoring acquisitions with noncontrast CT.
Consecutive patients with a history of MI who were referred for contrast-enhanced MDCT from November 2006 until March 2009 were studied. Noncontrast CT for CAC scoring was also performed. The correlation between regional myocardial hypoenhancement on contrast-enhanced CT and regional myocardial hypoattenuated areas on noncontrast CT was defined.
Eighty-three patients (mean age, 61.5+/-12.5 years; n=67; 81% male) with previous MI were studied. A total of 1411 myocardial segments were evaluated. Two hundred thirty-nine segments (17%) showed myocardial hypoenhancement by MDCT and 140 segments (9.6%) by CAC. On a patient level, noncontrast CT showed a sensitivity, specificity, positive predictive value, (PPV) and negative predictive value (NPV) of 66% (95% CI, 0.53-0.77), 100% (95% CI, 0.76-1.00), 100% (95% CI, 0.90-1.00), and 41% (95% CI, 0.26-0.58), respectively, to detect myocardial hypoenhancement. On a per segment level, noncontrast CT showed a sensitivity, specificity, PPV, and NPV of 58% (95% CI, 0.51-0.64), 100% (95% CI, 0.99-1.00), 99% (95% CI, 0.94-1.00), and 92% (95% CI, 0.90-0.93), respectively, to detect myocardial hypoenhancement.
Our findings suggest that chronic MI can be detected with standard CAC scoring acquisitions.
We explored whether regional myocardial hypoenhancement on contrast-enhanced MDCT could be identified with standard coronary artery calcium (CAC) scoring acquisitions with noncontrast CT.
Consecutive patients with a history of MI who were referred for contrast-enhanced MDCT from November 2006 until March 2009 were studied. Noncontrast CT for CAC scoring was also performed. The correlation between regional myocardial hypoenhancement on contrast-enhanced CT and regional myocardial hypoattenuated areas on noncontrast CT was defined.
Eighty-three patients (mean age, 61.5+/-12.5 years; n=67; 81% male) with previous MI were studied. A total of 1411 myocardial segments were evaluated. Two hundred thirty-nine segments (17%) showed myocardial hypoenhancement by MDCT and 140 segments (9.6%) by CAC. On a patient level, noncontrast CT showed a sensitivity, specificity, positive predictive value, (PPV) and negative predictive value (NPV) of 66% (95% CI, 0.53-0.77), 100% (95% CI, 0.76-1.00), 100% (95% CI, 0.90-1.00), and 41% (95% CI, 0.26-0.58), respectively, to detect myocardial hypoenhancement. On a per segment level, noncontrast CT showed a sensitivity, specificity, PPV, and NPV of 58% (95% CI, 0.51-0.64), 100% (95% CI, 0.99-1.00), 99% (95% CI, 0.94-1.00), and 92% (95% CI, 0.90-0.93), respectively, to detect myocardial hypoenhancement.
Our findings suggest that chronic MI can be detected with standard CAC scoring acquisitions.
Language
en
ISSN
1876-861X
eISSN
ISBN
DOI
10.1016/j.jcct.2009.12.003
PMID
20060800