Myocardial contrast delayed enhancement with 64-slice MDCT after acute MI

Myocardial contrast delayed enhancement with 64-slice MDCT after acute MI

Akira Sato, Toshihiro Nozato, Hiroyuki Hikita, Daiki Akiyama, Hidetaka Nishina, Tomoya Hoshi, Hideaki Aihara, Yuki Kakefuda, Hiroaki Watabe, Michiaki Hiroe and Kazutaka Aonuma have assessed the role of myocardial contrast delayed enhancement with 64-slice multidetector computerized tomography (MDCT) after acute myocardial infarction (MI) in prediction of clinical outcome [1]. Among the 102 patients, nine died and twelve had heart failure during the study period. The size of delayed enhancement on myocardial contrast CT was found to be a significant independent predictor for cardiac events after adjustment for TIMI (Thrombolysis In Myocardial Infarction) risk score, left ventricular ejection fraction and total defect score on technetium scan. The study was performed immediately after successful percutaneous coronary intervention (PCI). Multidetector CT was performed immediately after the final check angio of PCI procedure without administering any further contrast for the CT. Repeat angiograms were performed at six months after the PCI. Infarct area was defined as a hyperenhancement with a signal intensity higher than two standard deviations above the mean signal intensity of normal myocardium remote from the infarct location.

A smaller prior study had evaluated 30 patients with MDCT after primary PCI without further contrast administration [2]. They concluded that early detection of myocardial viability immediately after primary PCI with delayed enhancement MDCT was related to clinical and angiographic parameters of myocardial reperfusion.

Reference

1. Akira Sato, Toshihiro Nozato, Hiroyuki Hikita, Daiki Akiyama, Hidetaka Nishina, Tomoya Hoshi, Hideaki Aihara, Yuki Kakefuda, Hiroaki Watabe, Michiaki Hiroe, Kazutaka Aonuma. Prognostic Value of Myocardial Contrast Delayed Enhancement With 64-Slice Multidetector Computed Tomography After Acute Myocardial Infarction. J Am Coll Cardiol. 2012 Feb 21;59(8):730-8.
2. Gastón A Rodriguez-Granillo, Miguel A Rosales, Santiago Baum, Paola Rennes, Carlos Rodriguez-Pagani, Valeria Curotto, Carlos Fernandez-Pereira, Claudio Llaurado, Gustavo Risau, Elina Degrossi, Hernán C Doval, Alfredo E Rodriguez. Early Assessment of Myocardial Viability by the Use of Delayed Enhancement Computed Tomography After Primary Percutaneous Coronary Intervention. JACC Cardiovasc Imaging. 2009 Sep;2(9):1072-81.