title: Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study.
abstract: OBJECTIVE
  To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT).
  
  
  METHODS
  Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNRmyoc), blood pool SNR (SNRblood), contrast-to-noise ratio between blood pool and myocardium (CNRblood-myoc) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated.
  
  
  RESULTS
  Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNRmyoc of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 ± 1.9) and higher on delayed acquisition (7.10 ± 2.7) than control patients (6.1 ± 2.2 and 5.03 ± 1.8, respectively). Myocardial attenuation was higher in CA (121 ± 39 HU) than control patients (81 ± 17 HU) on delayed acquisition. CNRblood-myoc was significantly (p < 0.05) lower in CA (1.51 ± 0.7) than control patients (2.85 ± 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 ± 0.25) than in control patients (-0.56 ± 0.21).
  
  
  CONCLUSIONS
  Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA.
  
  
  CONCLUSIONS
  • CT can detect abnormal first-pass and delayed enhancement in cardiac amyloidosis. • Measurement of relative myocardial enhancement between acquisitions helps to detect cardiac amyloidosis. • CT may provide useful data to diagnose cardiac amyloidosis.
authors.affiliation: Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, University Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, 51 av Mal de Lattre de Tassigny, 94000, Créteil, France, jean-francois.deux@hmn.aphp.fr.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Deux
authors.forename: Cristian-Ionut
authors.initials: CI
authors.lastname: Mihalache
authors.forename: François
authors.initials: F
authors.lastname: Legou
authors.forename: Thibaud
authors.initials: T
authors.lastname: Damy
authors.forename: Julie
authors.initials: J
authors.lastname: Mayer
authors.forename: Stéphane
authors.initials: S
authors.lastname: Rappeneau
authors.forename: Violaine
authors.initials: V
authors.lastname: Planté-Bordeneuve
authors.forename: Alain
authors.initials: A
authors.lastname: Luciani
authors.forename: Hicham
authors.initials: H
authors.lastname: Kobeiter
authors.forename: Alain
authors.initials: A
authors.lastname: Rahmouni
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010865:Pilot Projects; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D059629:Signal-To-Noise Ratio
chemical_list: D003287:Contrast Media