Evaluating global and regional left ventricular function in patients with reperfused acute myocardial infarction by 64-slice multidetector CT: a comparison to magnetic resonance imaging.
BACKGROUND
A number of studies have compared 64-slice multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for left ventricular (LV) function; however, none were performed in patients with reperfused acute myocardial infarction.


OBJECTIVE
We compared global and regional LV function assessment by 64-slice CT (MDCT) with cardiac magnetic resonance (CMR) after reperfused ST elevation myocardial infarction.


METHODS
Twenty-one patients were scanned after reperfusion with contrast-enhanced CMR and MDCT. Reconstructed short axis images were used to assess global (quantitative assessment of LF end-diastolic volume [LVEDV], end-systolic volume [LVESV], stroke volume [LVSV], ejection fraction [LVEF], and mass, by Simpson's method) and regional cardiac function (qualitative assessment on a 4-point scale [4=normal, 3=hypokinesia, 2=dyskinesia, 1=akinesia]) in a standard 17-segment myocardial model.


RESULTS
We scanned 21 persons (age, 60+/-10 years; 19 men) with CMR and MDCT. Good correlation was observed for all global parameters between MDCT and CMR (LVEF, r=0.90; LVEDV, r=0.91; LVESV, r=0.94; LVSV, r=0.84; LV mass, r=0.91). Interobserver agreement for regional function was excellent (weighted kappa, 0.81). The interobserver agreement for regional function on MDCT and CMR were comparable (weighted kappa of 0.86 and 0.88, respectively). MDCT had a better sensitivity, specificity, positive predictive value, and negative predictive value for akinetic segments on CMR than did hypokinetic segments (71%, 91%, 68%, and 93% versus 84%, 97%, 81%, and 98%, respectively).


CONCLUSIONS
MDCT provides an accurate and reproducible measurement of regional and global LV function in patients with reperfused acute myocardial infarction.
Sarwar
Ammar
A
Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA.
Shapiro
Michael D
MD
Nasir
Khurram
K
Nieman
Koen
K
Nomura
Cesar H
CH
Brady
Thomas J
TJ
Cury
Ricardo C
RC
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis*; D015588:Observer Variation; D014057:Tomography, X-Ray Computed / Q000379:methods; D016277:Ventricular Function, Left