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The culprit lesion and its consequences: combined visualization of the coronary arteries and delayed myocardial enhancement in dual-source CT: a pilot study

  • Cardiac
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Abstract

Objective:

To assess combined analysis of coronary arteries and delayed myocardial contrast enhancement based on co-registration of coronary CT angiography and late-phase CT and automatic segmentation.

Materials and methods:

Co-registration and late enhancement segmentation were applied to coronary CT angiography and late-phase CT images from six pigs with acute myocardial infarction (MI) and six patients with chronic MI. MI size was quantified by manual delineation, the established 3SD method, and a new mixture model approach. Correspondence between coronary artery lesions and MI was assessed visually from fused segmentation results.

Results:

Co-registration was successful in all cases. There was substantial agreement in the number of segments diagnosed with MI, comparing manual delineation and the mixture model for animal (κ = 0.839) and patient studies (κ = 0.770). There were no significant differences between the two methods (P > 0.05). In patients there was a discrepancy between the segmental distribution of MI and empirical coronary artery perfusion in 10/96 segments when compared with the true coronary branching pattern.

Conclusion:

The mixture model approach is well suited for automated assessment of MI size from late-phase cardiac CT. Fusion imaging eliminates the need for empirical knowledge of the anatomical relationship between the coronary artery lesion and the area of myocardial ischaemia.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany

    Andreas H. Mahnken & Philipp Bruners

  2. Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany

    Andreas H. Mahnken & Philipp Bruners

  3. Fraunhofer MEVIS, Bremen, Germany

    Ola Friman & Anja Hennemuth

Authors
  1. Andreas H. Mahnken
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  2. Philipp Bruners
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  3. Ola Friman
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  4. Anja Hennemuth
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Correspondence to Andreas H. Mahnken.

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Mahnken, A.H., Bruners, P., Friman, O. et al. The culprit lesion and its consequences: combined visualization of the coronary arteries and delayed myocardial enhancement in dual-source CT: a pilot study. Eur Radiol 20, 2834–2843 (2010). https://doi.org/10.1007/s00330-010-1864-x

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  • DOI: https://doi.org/10.1007/s00330-010-1864-x

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