Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions.
AuthorsRodríguez-Granillo, Gastón A
Rosales, Miguel A
De Lillo, Gustavo
Rodriguez, Alfredo E
McFadden, Eugene P
AffiliationDepartment of Cardiovascular Imaging, Otamendi Hospital, Azcuenaga 870 (C1115AAB), Buenos Aires, Argentina. email@example.com
Tomography, X-Ray Computed
Ventricular Function, Left
MetadataShow full item record
CitationChronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions., 4 (2):99-107 J Cardiovasc Comput Tomogr
JournalJournal of cardiovascular computed tomography
AbstractHypoenhanced 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.
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