Evaluation of reperfused myocardial infarction by low-dose multidetector computed tomography using prospective electrocardiography (ECG)-triggering: comparison with magnetic resonance imaging.
OBJECTIVE
To evaluate the potential of prospective electrocardiography (ECG)- gated 64-slice multidetector computed tomography (MDCT) for evaluation of myocardial enhancement, infarct size, and stent patency after percutaneous coronary intervention (PCI) with stenting in patients with myocardial infarction.


METHODS
Seventeen patients who were admitted with acute myocardial infarction were examined with prospective ECG-gated 64-slice cardiac MDCT and magnetic resonance (MR) imaging after reperfusion using PCI with stenting. Cardiac MDCT was performed with two different phases: arterial and delayed phases. We evaluated the stent patency on the arterial phase, and nonviable myocardium on the delayed phase of computed tomography (CT) image, and they were compared with the results from the delayed MR images.


RESULTS
Total mean radiation dose was 7.7 +/- 0.5 mSv on the two phases of CT images. All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images. All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 +/- 10% vs. 22 +/- 10%, r = 0.935, p = 0.10). Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 +/- 17.8% vs. 4.3 +/- 2.1%, p < 0.001).


CONCLUSIONS
Prospective ECG-gated 64-slice MDCT provides the potential to evaluate myocardial viability on delayed phase as well as for stent patency on arterial phase with an acceptable radiation dose after PCI with stenting in patients with myocardial infarction.
Gweon
Hye Mi
HM
Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Kim
Sang Jin
SJ
Kim
Tae Hoon
TH
Lee
Sang Min
SM
Hong
Yoo Jin
YJ
Rim
Se-Joong
SJ
Hong
Bum Ki
BK
Min
Phil Ki
PK
Yoon
Young Won
YW
Kwon
Hyuck Moon
HM
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology* / Q000628:therapy; D015425:Myocardial Reperfusion; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*