title: Diagnostic accuracy of myocardial hypoenhancement on multidetector computed tomography in identifying myocardial infarction in patients admitted with acute chest pain syndrome.
abstract: OBJECTIVE
  To evaluate prevalence and diagnostic accuracy of myocardial hypoenhancement (MH) using multidetector computed tomography (MDCT) in patients admitted for acute chest pain syndromes.
  
  
  METHODS
  Sixty-nine patients underwent first-pass MDCT, coronary angiography, and echocardiography. Using a standardized analysis protocol, left ventricular short-axis reformations were evaluated for presence, size, and density of MH in 16 myocardial segments. These were correlated with the presence and location of myocardial infarction (MI), regional myocardial dysfunction, and coronary artery disease.
  
  
  RESULTS
  Myocardial hypoenhancement was found in acute MI (27/35), healed MI (6/14), unstable angina (3/9), and atypical chest pain (0/11). Sensitivity, specificity, and positive and negative predictive values of MH for diagnosing any MI were 67%, 85%, 92% and 52%, respectively.
  
  
  CONCLUSIONS
  The presence of MH on MDCT in acute chest pain patients has high positive predictive value and specificity but only moderate sensitivity for presence of acute or healed MI using the strict criteria proposed in this study.
authors: Cardiology Department, Rambam Medical Center and Technion-IIT, Haifa, Israel. j_lessick@rambam.health.gov.il
authors: Jonathan
authors: J
authors: Lessick
authors: Eduard
authors: E
authors: Ghersin
authors: Robert
authors: R
authors: Dragu
authors: Diana
authors: D
authors: Litmanovich
authors: Diab
authors: D
authors: Mutlak
authors: Shmuel
authors: S
authors: Rispler
authors: Yoram
authors: Y
authors: Agmon
authors: Ahuva
authors: A
authors: Engel
authors: Rafael
authors: R
authors: Beyar
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D002637:Chest Pain / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide