Assessment of myocardial delayed enhancement with cardiac computed tomography in cardiomyopathies: a prospective comparison with delayed enhancement cardiac magnetic resonance imaging

  • Hye-Jeong Lee
  • Dong Jin Im
  • Jong-Chan Youn
  • Suyon Chang
  • Young Joo Suh
  • Yoo Jin Hong
  • Young Jin Kim
  • Jin Hur
  • Byoung Wook ChoiEmail author
Original Paper


To evaluate the feasibility of cardiac CT for the evaluation of myocardial delayed enhancement (MDE) in the assessment of patients with cardiomyopathy, compared to cardiac MRI. A total of 37 patients (mean age 54.9 ± 15.7 years, 24 men) who underwent cardiac MRI to evaluate cardiomyopathy were enrolled. Dual-energy ECG-gated cardiac CT was acquired 12 min after contrast injection. Two observers evaluated cardiac MRI and cardiac CT at different kV settings (100, 120 and 140 kV) independently for MDE pattern-classification (patchy, transmural, subendocardial, epicardial and mesocardial), differentiation between ischemic and non-ischemic cardiomyopathy and MDE quantification (percentage MDE). Kappa statics and the intraclass correlation coefficient were used for statistical analysis. Among different kV settings, 100-kV CT showed excellent agreements compared to cardiac MRI for MDE detection (κ = 0.886 and 0.873, respectively), MDE pattern-classification (κ = 0.888 and 0.881, respectively) and differentiation between ischemic and non-ischemic cardiomyopathy (κ = 1.000 and 0.893, respectively) for both Observer 1 and Observer 2. The Bland–Altman plot between MRI and 100-kV CT for the percentage MDE showed a very small bias (−0.15%) with 95% limits of agreement of −7.02 and 6.72. Cardiac CT using 100 kV might be an alternative method to cardiac MRI in the assessment of cardiomyopathy, particularly in patients with contraindications to cardiac MRI.


Cardiomyopathy Myocardial delayed enhancement Myocardial fibrosis Cardiac computed tomography Cardiac magnetic resonance imaging 



This study was supported by a grant of LG life science (4-2010-0210).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national reaserch committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Hye-Jeong Lee
    • 1
  • Dong Jin Im
    • 1
  • Jong-Chan Youn
    • 2
  • Suyon Chang
    • 1
  • Young Joo Suh
    • 1
  • Yoo Jin Hong
    • 1
  • Young Jin Kim
    • 1
  • Jin Hur
    • 1
  • Byoung Wook Choi
    • 1
    Email author
  1. 1.Department of Radiology, Research Institute of Radiological Science, Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  2. 2.Division of Cardiology, Cardiovascular Hospital, Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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