Differentiation of Recent and Chronic Myocardial Infarction by Cardiac Computed Tomography

Koen Nieman, Ricardo C. Cury, Maros Ferencik, Cesar H. Nomura, Suhny Abbara, Udo Hoffmann, Herman K. Gold, Ik Kyung Jang, Thomas J. Brady

    Research output: Contribution to journalArticle

    92 Scopus citations

    Abstract

    Clinical use of cardiac computed tomography is rapidly expanding, and its purpose may reach beyond noninvasive coronary angiography. We investigated the ability of 64-slice multidetector computed tomography to differentiate between recent and long-standing myocardial infarction (MI). Contrast-enhanced coronary computed tomographic (CT) scans (Siemens Sensation 64) of patients with a recent MI (<7 days, n = 16), long-standing MI (>12 months, n = 13), and no MI (n = 13) were retrospectively evaluated. To anticipate transmural variation of myocardial perfusion and to neutralize image noise, a series of thin, overlapping slices was created in parallel alignment to the myocardial wall. Within each of these slices, a small region of interest was placed at a constant in-plane position to measure the CT attenuation (Hounsfield units [HU]) at consecutive transmural locations of injured and normal remote myocardium. In addition, wall thickness and the myocardial cavity were measured. Significantly lower CT attenuation values were found in patients with long-standing MI (-13 ± 37 HU) than in those with acute MI (26 ± 26HU) and normal controls (73 ± 14 HU, p <0.001). The attenuation difference between infarcted and remote myocardia was larger in patients with long-standing MI than in patients with recent MI (89 ± 41 and 55 ± 33 HU, respectively, p <0.001). In addition, long-standing MI was associated with wall thinning (p <0.01), and ventricular dilation (p <0.05), whereas recent MI was not (p >0.05). In conclusion, recent and long-standing MIs may be differentiated by computed tomography based on myocardial CT attenuation values and ventricular dimensions.

    Original languageEnglish (US)
    Pages (from-to)303-308
    Number of pages6
    JournalAmerican Journal of Cardiology
    Volume98
    Issue number3
    DOIs
    StatePublished - Aug 1 2006

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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    Nieman, K., Cury, R. C., Ferencik, M., Nomura, C. H., Abbara, S., Hoffmann, U., Gold, H. K., Jang, I. K., & Brady, T. J. (2006). Differentiation of Recent and Chronic Myocardial Infarction by Cardiac Computed Tomography. American Journal of Cardiology, 98(3), 303-308. https://doi.org/10.1016/j.amjcard.2006.01.101