Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions

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• 作者：Gastó ; n A. Rodrí ; guez-Granillo ; MD ; PhD^a ; ^b ; ^{grodriguezgranillo@gmail.com} ; Miguel A. Rosales ; MD^a ; Paola Renes ; MD^a ; Eduardo Diez ; MD^c ; Jorge Pereyra ; MD^c ; Estela Gomez ; MD^c ; Gustavo De Lillo ; MD^c ; Elina Degrossi ; MD^a ; Alfredo E. Rodriguez ; MD ; PhD ; FACC^a ; Eugene P. McFadden ; MD ; FRCPI ; FACC^d
• 关键词：Computed tomography ; Infarct extension ; Necrosis ; Perfusion defect
• 刊名：Journal of Cardiovascular Computed Tomography
• 出版年：2010
• 出版时间：March-April 2010
• 年：2010
• 卷：4
• 期：2
• 页码：99-107
• 全文大小：645 K

文摘

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Background

Hypoenhanced regions on multidetector CT (MDCT) coronary angiography correlate with myocardial hyperperfusion. In addition to a limited capillary density, chronic myocardial infarction (MI) commonly contains a considerable amount of adipose tissue.

Objective

We explored whether regional myocardial hypoenhancement on contrast-enhanced MDCT could be identified with standard coronary artery calcium (CAC) scoring acquisitions with noncontrast CT.

Methods

Consecutive patients with a history of MI who were referred for contrast-enhanced MDCT from November 2006 until March 2009 were studied. Noncontrast CT for CAC scoring was also performed. The correlation between regional myocardial hypoenhancement on contrast-enhanced CT and regional myocardial hypoattenuated areas on noncontrast CT was defined.

Results

Eighty-three patients (mean age, 61.5 ¡À 12.5 years; n = 67; 81 % male) with previous MI were studied. A total of 1411 myocardial segments were evaluated. Two hundred thirty-nine segments (17 % ) showed myocardial hypoenhancement by MDCT and 140 segments (9.6 % ) by CAC. On a patient level, noncontrast CT showed a sensitivity, specificity, positive predictive value, (PPV) and negative predictive value (NPV) of 66 % (95 % CI, 0.53?.77), 100 % (95 % CI, 0.76?.00), 100 % (95 % CI, 0.90?.00), and 41 % (95 % CI, 0.26?.58), respectively, to detect myocardial hypoenhancement. On a per segment level, noncontrast CT showed a sensitivity, specificity, PPV, and NPV of 58 % (95 % CI, 0.51?.64), 100 % (95 % CI, 0.99?.00), 99 % (95 % CI, 0.94?.00), and 92 % (95 % CI, 0.90?.93), respectively, to detect myocardial hypoenhancement.

Conclusions

Our findings suggest that chronic MI can be detected with standard CAC scoring acquisitions.