title: Assessment of myocardial viability in reperfused acute myocardial infarction using 16-slice computed tomography in comparison to magnetic resonance imaging.
abstract: OBJECTIVE
  The aim of this study was to examine if contrast-enhanced multislice spiral computed tomography (MSCT) is comparable to contrast-enhanced magnetic resonance imaging (MRI) for depiction of acute myocardial infarction (MI).
  
  
  BACKGROUND
  Delayed-enhancement MRI of MI is well established, but there are no clinical reports about MSCT for this indication. Early perfusion deficit on MSCT has been reported to correlate with the presence of MI.
  
  
  METHODS
  A total of 28 consecutive patients (23 men; 55.9 +/- 11.4 years) with reperfused MI underwent contrast-enhanced cardiac 16-slice MSCT. Images were acquired in the arterial phase and the late phase 15 min after administration of 120 ml contrast material. Within 5 days, patients underwent MRI after administration of 0.2 mmol Gd-dimeglumine/kg/bodyweight. All examinations were completed within two weeks after MI. The area of MI was compared between the different imaging techniques using Bland-Altman method and multivariate analysis. Agreement of the contrast enhancement patterns was evaluated with a weighted kappa test.
  
  
  RESULTS
  Mean infarct size on MRI was 31.2 +/- 22.5% per slice compared with 33.3 +/- 23.8% per slice for late-enhancement MSCT and 24.5 +/- 18.3% per slice for early-perfusion-deficit MSCT. Bland-Altman data showed a good agreement between late-enhancement MRI and late-enhancement MSCT. Contrast enhancement patterns demonstrated an excellent agreement between late-enhancement MRI and late-enhancement MSCT (kappa = 0.878). The results were worse comparing MRI and early-phase MSCT (kappa = 0.635).
  
  
  CONCLUSIONS
  Multislice spiral computed tomography allows for the assessment of acute MI. Late-enhancement MSCT appears to be as reliable as delayed contrast-enhanced MRI in assessing infarct size and myocardial viability in acute MI.
authors.affiliation: Diagnostic Radiology, University-Hospital, Pauwelsstrasse 30. D-52074 Aachen, Germany. mahnken@rad.rwth-aachen.de
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mahnken
authors.forename: Ralf
authors.initials: R
authors.lastname: Koos
authors.forename: Marcus
authors.initials: M
authors.lastname: Katoh
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: Elmar
authors.initials: E
authors.lastname: Spuentrup
authors.forename: Arno
authors.initials: A
authors.lastname: Buecker
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
authors.forename: Harald P
authors.initials: HP
authors.lastname: Kühl
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003326:Coronary Circulation; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D015425:Myocardial Reperfusion; D011446:Prospective Studies; D015203:Reproducibility of Results; D036542:Tomography, Spiral Computed
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D019786:Gadolinium DTPA