title: Multidetector-row computed tomographic evaluation of myocardial perfusion in reperfused chronic myocardial infarction: value of color-coded perfusion map in a porcine model.
abstract: We aimed to develop color-coded CT perfusion maps (CPM) of infarcted myocardium and assess the utility of CPM in evaluating ischemic heart disease on a cardiac multi-detector CT (MDCT) in a porcine reperfused-myocardial-infarction model. Myocardial infarctions were induced by 30 min occlusions of the proximal left anterior descending coronary artery (LAD) in 17 healthy adult female pigs. First-pass and 5 min-delayed cardiac MDCTs were performed after 4 weeks of LAD occlusion. Myocardial CPMs were obtained by using the CPM program. Triphenyltetrazolium chloride (TTC)-staining was performed on the cardiac specimens. We analyzed the intermodality agreement on the size and location of the myocardial infarctions. TTC staining revealed myocardial infarction in 16 of 17 pigs, and 15 of these (94%) showed matched infarcts on the CPM and first-pass images. The areas of perfusion deficit noted in early arterial phase images and CPM coincided exactly with the areas of poor TTC staining in 12 of 15 pigs (80%). In the three remaining pigs, the areas of poor TTC staining were larger than those of a perfusion deficit demonstrated by either early arterial phase images or CPM. The agreement between these tests is calculated to be moderate to good (k = 0.736, P < 0.05). Ten myocardial segments in 4 of the 15 pigs (27%) with hypoattenuated myocardium showed a delayed enhancement on the 5 min-delayed images. Contrast-enhanced MDCT was useful and accurate in detecting chronic myocardial infarction; CPM was helpful in visualizing the infarcted myocardium.
authors.affiliation: Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, #8 Hackdong, Dongku, Gwangju 501-757, South Korea.
authors.forename: Nam Yeol
authors.initials: NY
authors.lastname: Yim
authors.forename: Yun-Hyeon
authors.initials: YH
authors.lastname: Kim
authors.forename: Song
authors.initials: S
authors.lastname: Choi
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Seon
authors.forename: Yeong Cheol
authors.initials: YC
authors.lastname: Kim
authors.forename: Gwang Woo
authors.initials: GW
authors.lastname: Jeong
authors.forename: Byeong In
authors.initials: BI
authors.lastname: Min
authors.forename: Sang Rok
authors.initials: SR
authors.lastname: Lee
authors.forename: Myeong Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Jae Kyu
authors.initials: JK
authors.lastname: Kim
authors.forename: Jin Gyoon
authors.initials: JG
authors.lastname: Park
authors.forename: Heoung Keun
authors.initials: HK
authors.lastname: Kang
mesh_terms: D000818:Animals; D002908:Chronic Disease; D004396:Coloring Agents; D003326:Coronary Circulation; D004195:Disease Models, Animal; D005260:Female; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D013552:Swine; D013778:Tetrazolium Salts; D014057:Tomography, X-Ray Computed
chemical_list: D004396:Coloring Agents; D013778:Tetrazolium Salts; C009591:triphenyltetrazolium