Low dose prospective ECG-gated delayed enhanced dual-source computed tomography in reperfused acute myocardial infarction comparison with cardiac magnetic resonance.

PURPOSE

To determine whether prospective electrocardiogram (ECG)-gated delayed contrast-enhanced dual-source computed tomography (DCE-DSCT) can accurately delineate the extension of myocardial infarction (MI) compared with delayed enhanced cardiac MR (DE-MR).

MATERIAL AND METHODS

Eleven patients were examined using dual-source CT and cardiac MR in 2 weeks after a first reperfused MI. DCE-DSCT scan protocol was performed with prospective ECG-gating sequential scan model 7 min after contrast administration. In a 17-model, infarcted myocardium detected by DE-MR was categorized as transmural and subendocardial extension. Segment of infarcted location and graded transmurality were compared between DCE-MDCT and DE-MR.

RESULTS

In all eleven patients, diagnostic quality was obtained for depicting delayed enhanced myocardium. Agreement between DCE-DSCT and MR was good on myocardial segment based comparison (kappa=0.85, p<0.001), and on transmural and subendocardial infarction type comparison (kappa=0.82, p<0.001, kappa=0.52, p<0.001, respectively). CT value was higher on infarcted region than that of normal region (100.02±9.57 HU vs. 72.63±7.32 HU, p<0.001). Radiation dose of prospectively ECG-gating protocol were 0.99±0.08 mSv (0.82-1.19 mSv).

CONCLUSIONS

Prospective ECG-gated DCE-DSCT can accurately assess the extension and the patterns of myocardial infarction with low radiation dose.