Evaluating global and regional left ventricular function in patients with reperfused acute myocardial infarction by 64-slice multidetector CT: A comparison to magnetic resonance imaging

Sarwar, Ammar; Shapiro, Michael D.; Nasir, Khurram; Nieman, Koen; Nomura, Cesar H.; Brady, Thomas J.; Cury, Ricardo C.

doi:10.1016/j.jcct.2009.05.002

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 3, Issue 3 , Pages 170-177, May 2009

Evaluating global and regional left ventricular function in patients with reperfused acute myocardial infarction by 64-slice multidetector CT: A comparison to magnetic resonance imaging

Ammar Sarwar, MD
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA 02114
Michael D. Shapiro
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA 02114
Khurram Nasir, MD, MPH
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA 02114
Koen Nieman
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA 02114
Cesar H. Nomura
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA 02114
Thomas J. Brady, MD
- Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA 02114
Ricardo C. Cury, MD
- Baptist Cardiac and Vascular Institute, 8900 N Kendall Drive, Miami, FL 33176
- Corresponding author.

Received 22 November 2008; accepted 4 May 2009. published online 13 May 2009.

Background

A number of studies have compared 64-slice multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for left ventricular (LV) function; however, none were performed in patients with reperfused acute myocardial infarction.

Objectives

We compared global and regional LV function assessment by 64-slice CT (MDCT) with cardiac magnetic resonance (CMR) after reperfused ST elevation myocardial infarction.

Methods

Twenty-one patients were scanned after reperfusion with contrast-enhanced CMR and MDCT. Reconstructed short axis images were used to assess global (quantitative assessment of LF end-diastolic volume [LVEDV], end-systolic volume [LVESV], stroke volume [LVSV], ejection fraction [LVEF], and mass, by Simpson's method) and regional cardiac function (qualitative assessment on a 4-point scale [4=normal, 3=hypokinesia, 2=dyskinesia, 1=akinesia]) in a standard 17-segment myocardial model.

Results

We scanned 21 persons (age, 60±10 years; 19 men) with CMR and MDCT. Good correlation was observed for all global parameters between MDCT and CMR (LVEF, r=0.90; LVEDV, r=0.91; LVESV, r=0.94; LVSV, r=0.84; LV mass, r=0.91). Interobserver agreement for regional function was excellent (weighted κ, 0.81). The interobserver agreement for regional function on MDCT and CMR were comparable (weighted κ of 0.86 and 0.88, respectively). MDCT had a better sensitivity, specificity, positive predictive value, and negative predictive value for akinetic segments on CMR than did hypokinetic segments (71%, 91%, 68%, and 93% versus 84%, 97%, 81%, and 98%, respectively).