title: Myocardial SPECT perfusion defect size compared to infarct size by delayed gadolinium-enhanced magnetic resonance imaging in patients with acute or chronic infarction.
abstract: BACKGROUND
  Single photon emission computed tomography (SPECT) perfusion imaging has been considered a reference method for non-invasive estimation of infarct size in man. Recently, delayed gadolinium-enhanced magnetic resonance imaging (DE-MRI) has evolved as an accurate tool to quantify infarct size. Therefore, the present study was designed to compare perfusion defect size by SPECT to hyperenhanced volume by DE-MRI.
  
  
  METHODS
  DE-MRI was performed in 30 patients. Fourteen were patients with revascularized first-time acute infarctions, eight revascularized chronic infarctions, and eight clinically referred non-revascularized patients. SPECT was performed in the same patients and analysed by a commercial package.
  
  
  RESULTS
  The hypoperfused volume by SPECT was larger than the hyperenhanced volume by DE-MRI by 8 +/- 8 ml (6% +/- 5 percentage points), 10 +/- 18 ml (6% +/- 11 percentage points), and 26 +/- 30 ml (12% +/- 10 percentage points) in the acute, chronic and clinical populations, respectively. Left ventricle wall volume was smaller by SPECT in all settings.
  
  
  CONCLUSIONS
  The SPECT perfusion defect size was comparable with but generally slightly larger than the hyperenhanced volume by DE-MRI in both absolute and relative terms in patients with acute and chronic infarction. The results may be related to systematic differences between modalities but could also be influenced by biological phenomena such as wall thinning or hypoperfused but viable myocardium.
authors.affiliation: Department of Clinical Physiology, Lund University Hospital, SE-221 85 Lund, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Hedström
authors.forename: John
authors.initials: J
authors.lastname: Palmer
authors.forename: Martin
authors.initials: M
authors.lastname: Ugander
authors.forename: Håkan
authors.initials: H
authors.lastname: Arheden
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006571:Heterocyclic Compounds; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification* / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000145:classification* / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate