From the Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Invest Radiol. 2013 Dec;48(12):851-6. doi: 10.1097/RLI.0b013e31829d91a8.
The purpose of the study was to compare the performance of late iodine-enhancement (LIE) dual-energy computed tomography (DECT) linear blending and selective myocardial iodine mapping for the detection of chronic myocardial infarction (CMI) with late gadolinium-enhancement (LGE) 3-T magnetic resonance imaging.
This study was approved by the institutional review board, and the patients gave informed consent. A total of 20 patients with a history of CMI underwent cardiac LIE-DECT and LGE-MRI. Images of the LIE-DECT were reconstructed as 100 kilovolt (peak) (kV[p]), 140 kV(p), and weighted-average (WA; linear blending) images from low- and high-kilovoltage peak data using 3 different weighting factors (0.8, 0.6, 0.3). Additional color-coded myocardial iodine distribution maps were calculated. The images were reviewed for the presence of late enhancement, transmural extent, signal characteristics, infarct volume, and subjective image quality.
Segmental analysis of LIE-DECT data from 100 kV(p), WA of 0.8, and WA of 0.6 showed identical results for the identification of CMI (89% sensitivity, 98% specificity, 96% accuracy) and correctly identified all segments with transmural scarring detected through LGE-MRI. Weighted average of 0.6 received the best subjective image quality rating (15/20 votes) and average measured infarct size correlated best with LGE-MRI (5.7% difference). In comparison with LGE-MRI, iodine distribution maps were susceptible to false-positive and false-negative findings (52% sensitivity, 88% specificity, 81% accuracy), overestimating quantity of transmural scars by 78% while underestimating infarct volume by 55%.
Late iodine enhancement cardiac dual-energy computed tomography correlates well with LGE-MRI for detecting CMI, whereas iodine distribution analysis provides inferior accuracy. Linear blending further improves image quality and enables more precise estimation of scar volume.
本研究旨在比较晚期碘增强（LIE）双能 CT（DECT）线性融合与选择性心肌碘图在检测慢性心肌梗死（CMI）中的表现，与钆延迟增强（LGE）3T 磁共振成像进行比较。
本研究经机构审查委员会批准，患者均签署知情同意书。共 20 例有 CMI 病史的患者接受了心脏 LIE-DECT 和 LGE-MRI 检查。LIE-DECT 图像由低千伏峰（peak）（kV[p]）和高千伏峰数据的 3 种不同权重因子（0.8、0.6、0.3）重建为 100kV[p]、140kV[p]和加权平均（WA；线性融合）图像。计算了额外的彩色编码心肌碘分布图。评估了晚期强化、透壁程度、信号特征、梗死体积和主观图像质量。
100kV[p]、WA 0.8 和 WA 0.6 的 LIE-DECT 数据的节段分析对 CMI 的识别结果相同（89%的灵敏度、98%的特异性、96%的准确性），并正确识别了所有通过 LGE-MRI 检测到的透壁性瘢痕节段。WA 0.6 的加权平均获得了最佳的主观图像质量评分（20 票中有 15 票），平均测量的梗死面积与 LGE-MRI 相关性最好（5.7%的差异）。与 LGE-MRI 相比，碘分布图易出现假阳性和假阴性结果（52%的灵敏度、88%的特异性、81%的准确性），高估透壁性瘢痕的数量 78%，低估梗死体积 55%。
晚期碘增强心脏双能 CT 与 LGE-MRI 检测 CMI 相关性良好，而碘分布分析的准确性较低。线性融合进一步提高了图像质量，并能更准确地估计瘢痕体积。
