title: Multidetector row computed tomography noninvasively assesses coronary reperfusion after thrombolytic therapy in patients with ST elevation myocardial infarction.
abstract: BACKGROUND
  The study objective was to assess the efficacy of 16-slice multidetector row computed tomography (MDCT) in estimating residual stenosis and successful reperfusion after thrombolysis in patients with ST-elevation myocardial infarction (STEMI).
  
  
  RESULTS
  A total of 31 patients with STEMI underwent MDCT scanning within 6 h (mean 4.6+/-1.1) after thrombolysis and the results for detection of significant residual stenosis and distal flow of the infarct-related artery were compared with those from conventional coronary angiography (CCAG) performed within 24 h (mean 12.1+/-5.6) after the MDCT scan. Successful reperfusion was defined as Thrombolysis In Myocardial Infarction flow 2 or 3 on CCAG and full contrast enhancement of the distal artery landmarks on MDCT. A final analysis was performed using 24 patients (312 segments). MDCT had a positive predictive value of 73.3% and a negative predictive value of 95.1% for detecting significant residual stenosis. It accurately estimated 17 of 18 patients (94.4%) with successful reperfusion and 5 of 6 (83.3%) with failed reperfusion on the basis of comparison with CCAG.
  
  
  CONCLUSIONS
  MDCT demonstrated high accuracy not only for the detecting residual stenosis, but also for assessing successful reperfusion after thrombolytic therapy in patients with STEMI.
authors.affiliation: Department of Internal Medicine, The catholic University of Korea, Seoul, South Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Shin
authors.forename: Yoo Dong
authors.initials: YD
authors.lastname: Won
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
authors.forename: Woo
authors.initials: W
authors.lastname: Seung
authors.forename: Pum Joon
authors.initials: PJ
authors.lastname: Kim
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Park
authors.forename: Hae Ok
authors.initials: HO
authors.lastname: Jung
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Jeon
authors.forename: Sang Hong
authors.initials: SH
authors.lastname: Baek
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kim
authors.forename: Youn-Jeong
authors.initials: YJ
authors.lastname: Kim
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
mesh_terms: D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed / Q000379:methods*