Kitagawa K, Sakuma H, Hirano T, Okamoto S, Makino K, Takeda K. Acute myocardial infarction: myocardial viability assessment in patients early thereafter comparison of contrast-enhanced MR imaging with resting (201)Tl SPECT. Single photon emission computed tomography.
Radiology 2003;
226:138-44. [PMID:
12511682 DOI:
10.1148/radiol.2261012108]
[Citation(s) in RCA: 83] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE
To compare contrast material-enhanced magnetic resonance (MR) imaging with resting thallium 201 ((201)Tl) single photon emission computed tomography (SPECT) for predicting myocardial viability in patients early after acute myocardial infarction.
MATERIALS AND METHODS
Inversion-recovery contrast-enhanced MR images and resting (201)Tl SPECT images were obtained in 22 patients after acute myocardial infarction. The (201)Tl SPECT images were obtained 4.3 days +/- 0.2 (standard error) after the onset of myocardial infarction. Contrast-enhanced MR imaging was performed 7.9 days +/- 1.6 after (201)Tl SPECT. Transmural extent of hyperenhancement on contrast-enhanced MR images and regional (201)Tl activity were quantitatively analyzed with a 12-segment model. Regional wall thickening on follow-up cine MR images obtained 67 days +/- 17 after contrast-enhanced MR imaging was used as an index for myocardial viability. Statistical analyses were performed with the chi(2) and two-tailed Student t tests.
RESULTS
Both contrast-enhanced MR and resting (201)Tl SPECT images showed significant correlations with regional wall thickening on follow-up cine MR images. The sensitivity, specificity, and accuracy of contrast-enhanced MR imaging in the prediction of viable myocardium were significantly higher than those of resting (201)Tl SPECT (98.0% vs 90.3%, P <.01; 75.0% vs 54.4%, P <.05; and 92.0% vs 81.1%, P <.001, respectively).
CONCLUSION
Delayed contrast-enhanced MR imaging can help predict myocardial viability as seen on follow-up cine MR images after acute myocardial infarction, with significantly improved sensitivity, specificity, and accuracy in comparison with those of resting (201)Tl SPECT.
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