Low dose prospective ECG-gated delayed enhanced dual-source computed tomography in reperfused acute myocardial infarction comparison with cardiac magnetic resonance.
OBJECTIVE
To determine whether prospective electrocardiogram (ECG)-gated delayed contrast-enhanced dual-source computed tomography (DCE-DSCT) can accurately delineate the extension of myocardial infarction (MI) compared with delayed enhanced cardiac MR (DE-MR).


METHODS
Eleven patients were examined using dual-source CT and cardiac MR in 2 weeks after a first reperfused MI. DCE-DSCT scan protocol was performed with prospective ECG-gating sequential scan model 7 min after contrast administration. In a 17-model, infarcted myocardium detected by DE-MR was categorized as transmural and subendocardial extension. Segment of infarcted location and graded transmurality were compared between DCE-MDCT and DE-MR.


RESULTS
In all eleven patients, diagnostic quality was obtained for depicting delayed enhanced myocardium. Agreement between DCE-DSCT and MR was good on myocardial segment based comparison (kappa=0.85, p<0.001), and on transmural and subendocardial infarction type comparison (kappa=0.82, p<0.001, kappa=0.52, p<0.001, respectively). CT value was higher on infarcted region than that of normal region (100.02±9.57 HU vs. 72.63±7.32 HU, p<0.001). Radiation dose of prospectively ECG-gating protocol were 0.99±0.08 mSv (0.82-1.19 mSv).


CONCLUSIONS
Prospective ECG-gated DCE-DSCT can accurately assess the extension and the patterns of myocardial infarction with low radiation dose.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China. rui_wang1979@yahoo.cn
Rui
R
Wang
Zhaoqi
Z
Zhang
Lei
L
Xu
Qin
Q
Ma
Yi
Y
He
Dongxu
D
Lu
Wei
W
Yu
Zhanming
Z
Fan
D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide