title: Contrast-Enhanced C-arm Computed Tomography Imaging of Myocardial Infarction in the Interventional Suite.
abstract: OBJECTIVE
  Cardiac C-arm computed tomography (CT) uses a standard C-arm fluoroscopy system rotating around the patient to provide CT-like images during interventional procedures without moving the patient to a conventional CT scanner. We hypothesized that C-arm CT can be used to visualize and quantify the size of perfusion defects and late enhancement resulting from a myocardial infarction (MI) using contrast-enhanced techniques similar to previous CT and magnetic resonance imaging studies.
  
  
  METHODS
  A balloon occlusion followed by reperfusion in a coronary artery was used to study acute and subacute MI in 12 swine. Electrocardiographically gated C-arm CT images were acquired the day of infarct creation (n = 6) or 4 weeks after infarct creation (n = 6). The images were acquired immediately after contrast injection, then at 1 minute, and every 5 minutes up to 30 minutes with no additional contrast. The volume of the infarct as measured on C-arm CT was compared against pathology.
  
  
  RESULTS
  The volume of acute MI, visualized as a combined region of hyperenhancement with a hypoenhanced core, correlated well with pathologic staining (concordance correlation, 0.89; P < 0.0001; mean [SD] difference, 0.67 [2.98]cm3). The volume of subacute MI, visualized as a region of hyperenhancement, correlated well with pathologic staining at imaging times 5 to 15 minutes after contrast injection (concordance correlation, 0.82; P < 0.001; mean difference, -0.64 [1.94]cm3).
  
  
  CONCLUSIONS
  C-arm CT visualization of acute and subacute MI is possible in a porcine model, but improvement in the imaging technique is important before clinical use. Visualization of MI in the catheterization laboratory may be possible and could provide 3-dimensional images for guidance during interventional procedures.
authors: From the Departments of *Bioengineering; †Medicine, ‡Radiology, and §Comparative Medicine, Stanford University, Palo Alto, CA; ∥Siemens Medical Solutions Incorporation, Malvern, PA; and ¶Siemens AG, Healthcare, Forchheim, Germany.
authors: Erin E
authors: EE
authors: Girard
authors: Amin
authors: A
authors: Al-Ahmad
authors: Jarrett
authors: J
authors: Rosenberg
authors: Richard
authors: R
authors: Luong
authors: Teri
authors: T
authors: Moore
authors: Günter
authors: G
authors: Lauritsch
authors: Frandics
authors: F
authors: Chan
authors: David P
authors: DP
authors: Lee
authors: Rebecca
authors: R
authors: Fahrig
mesh_terms: D000818:Animals; D003287:Contrast Media; D004195:Disease Models, Animal; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D007089:Image Enhancement; D053783:Magnetic Resonance Imaging, Interventional; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D013552:Swine; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
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