Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT

Ricardo C. Cury, Koen Nieman, Michael Shapiro, Javed Butler, Cesar H. Nomura, Maros Ferencik, Udo Hoffmann, Suhny Abbara, Davinder S. Jassal, Tsunehiro Yasuda, Herman K. Gold, Ik Kyung Jang, Thomas J. Brady

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Abstract

Purpose: To evaluate the accuracy of 64-section multidetector computed tomography (CT) for the assessment of perfusion defects (PDs), regional wall motion (RWM), and global left ventricular (LV) function. Materials and Methods: All myocardial infarction (MI) patients signed informed consent. The IRB approved the study and it was HIPAA-compliant. Cardiac multidetector CT was performed in 102 patients (34 with recent acute MI and 68 without). Multidetector CT images were analyzed for myocardial PD, RWM abnormalities, and LV function. Global LV function and RWM were compared with transthoracic echocardiography (TTE) by using multidetector CT. PD was detected by using multidetector CT and was correlated with cardiac biomarkers and single photon emission CT (SPECT) myocardial perfusion imaging. Multidetector CT diagnosis of acute MI was made on the basis of matching the presence of PD with RWM abnormalities compared with clinical evaluation. Results: Correlation between multidetector CT and TTE for global function (r = 0.68) and RWM (κ = 0.79) was good. The size of PD on multidetector CT had a moderate correlation against SPECT (r = 0.48, -7% ± 9). There was good to excellent correlation between cardiac biomarkers and the percentage infarct size by using multidetector CT (r = 0.82 for creatinine phosphokinase, r = 0.76 for creatinine phosphokinase of the muscle band, and r = 0.75 for troponin). For detection of acute MI in patients, multidetector CT sensitivity was 94% (32 of 34) and specificity was 97% (66 of 68). Multidetector CT had an excellent interobserver reliability for ejection fraction quantification (r = 0.83), as compared with TTE (r = 0.68). Conclusion: Patients with acute MI can be identified by using multidetector CT on the basis of RWM abnormalities and PD.

Original languageEnglish (US)
Pages (from-to)466-475
Number of pages10
JournalRadiology
Volume248
Issue number2
DOIs
StatePublished - Aug 2008
Externally publishedYes

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Multidetector Computed Tomography
Left Ventricular Function
Perfusion
Myocardial Infarction
Echocardiography
Creatinine
Phosphotransferases
Biomarkers
Health Insurance Portability and Accountability Act
Myocardial Perfusion Imaging
Troponin
Research Ethics Committees
Single-Photon Emission-Computed Tomography
Informed Consent
Photons

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT. / Cury, Ricardo C.; Nieman, Koen; Shapiro, Michael; Butler, Javed; Nomura, Cesar H.; Ferencik, Maros; Hoffmann, Udo; Abbara, Suhny; Jassal, Davinder S.; Yasuda, Tsunehiro; Gold, Herman K.; Jang, Ik Kyung; Brady, Thomas J.

In: Radiology, Vol. 248, No. 2, 08.2008, p. 466-475.

Research output: Contribution to journalArticle

Cury, RC, Nieman, K, Shapiro, M, Butler, J, Nomura, CH, Ferencik, M, Hoffmann, U, Abbara, S, Jassal, DS, Yasuda, T, Gold, HK, Jang, IK & Brady, TJ 2008, 'Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT', Radiology, vol. 248, no. 2, pp. 466-475. https://doi.org/10.1148/radiol.2482071478
Cury, Ricardo C. ; Nieman, Koen ; Shapiro, Michael ; Butler, Javed ; Nomura, Cesar H. ; Ferencik, Maros ; Hoffmann, Udo ; Abbara, Suhny ; Jassal, Davinder S. ; Yasuda, Tsunehiro ; Gold, Herman K. ; Jang, Ik Kyung ; Brady, Thomas J. / Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT. In: Radiology. 2008 ; Vol. 248, No. 2. pp. 466-475.
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abstract = "Purpose: To evaluate the accuracy of 64-section multidetector computed tomography (CT) for the assessment of perfusion defects (PDs), regional wall motion (RWM), and global left ventricular (LV) function. Materials and Methods: All myocardial infarction (MI) patients signed informed consent. The IRB approved the study and it was HIPAA-compliant. Cardiac multidetector CT was performed in 102 patients (34 with recent acute MI and 68 without). Multidetector CT images were analyzed for myocardial PD, RWM abnormalities, and LV function. Global LV function and RWM were compared with transthoracic echocardiography (TTE) by using multidetector CT. PD was detected by using multidetector CT and was correlated with cardiac biomarkers and single photon emission CT (SPECT) myocardial perfusion imaging. Multidetector CT diagnosis of acute MI was made on the basis of matching the presence of PD with RWM abnormalities compared with clinical evaluation. Results: Correlation between multidetector CT and TTE for global function (r = 0.68) and RWM (κ = 0.79) was good. The size of PD on multidetector CT had a moderate correlation against SPECT (r = 0.48, -7{\%} ± 9). There was good to excellent correlation between cardiac biomarkers and the percentage infarct size by using multidetector CT (r = 0.82 for creatinine phosphokinase, r = 0.76 for creatinine phosphokinase of the muscle band, and r = 0.75 for troponin). For detection of acute MI in patients, multidetector CT sensitivity was 94{\%} (32 of 34) and specificity was 97{\%} (66 of 68). Multidetector CT had an excellent interobserver reliability for ejection fraction quantification (r = 0.83), as compared with TTE (r = 0.68). Conclusion: Patients with acute MI can be identified by using multidetector CT on the basis of RWM abnormalities and PD.",
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T1 - Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT

AU - Cury, Ricardo C.

AU - Nieman, Koen

AU - Shapiro, Michael

AU - Butler, Javed

AU - Nomura, Cesar H.

AU - Ferencik, Maros

AU - Hoffmann, Udo

AU - Abbara, Suhny

AU - Jassal, Davinder S.

AU - Yasuda, Tsunehiro

AU - Gold, Herman K.

AU - Jang, Ik Kyung

AU - Brady, Thomas J.

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N2 - Purpose: To evaluate the accuracy of 64-section multidetector computed tomography (CT) for the assessment of perfusion defects (PDs), regional wall motion (RWM), and global left ventricular (LV) function. Materials and Methods: All myocardial infarction (MI) patients signed informed consent. The IRB approved the study and it was HIPAA-compliant. Cardiac multidetector CT was performed in 102 patients (34 with recent acute MI and 68 without). Multidetector CT images were analyzed for myocardial PD, RWM abnormalities, and LV function. Global LV function and RWM were compared with transthoracic echocardiography (TTE) by using multidetector CT. PD was detected by using multidetector CT and was correlated with cardiac biomarkers and single photon emission CT (SPECT) myocardial perfusion imaging. Multidetector CT diagnosis of acute MI was made on the basis of matching the presence of PD with RWM abnormalities compared with clinical evaluation. Results: Correlation between multidetector CT and TTE for global function (r = 0.68) and RWM (κ = 0.79) was good. The size of PD on multidetector CT had a moderate correlation against SPECT (r = 0.48, -7% ± 9). There was good to excellent correlation between cardiac biomarkers and the percentage infarct size by using multidetector CT (r = 0.82 for creatinine phosphokinase, r = 0.76 for creatinine phosphokinase of the muscle band, and r = 0.75 for troponin). For detection of acute MI in patients, multidetector CT sensitivity was 94% (32 of 34) and specificity was 97% (66 of 68). Multidetector CT had an excellent interobserver reliability for ejection fraction quantification (r = 0.83), as compared with TTE (r = 0.68). Conclusion: Patients with acute MI can be identified by using multidetector CT on the basis of RWM abnormalities and PD.

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