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Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study

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Abstract

Objectives

To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT).

Methods

Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNRmyoc), blood pool SNR (SNRblood), contrast-to-noise ratio between blood pool and myocardium (CNRblood-myoc) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated.

Results

Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNRmyoc of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 ± 1.9) and higher on delayed acquisition (7.10 ± 2.7) than control patients (6.1 ± 2.2 and 5.03 ± 1.8, respectively). Myocardial attenuation was higher in CA (121 ± 39 HU) than control patients (81 ± 17 HU) on delayed acquisition. CNRblood-myoc was significantly (p < 0.05) lower in CA (1.51 ± 0.7) than control patients (2.85 ± 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 ± 0.25) than in control patients (−0.56 ± 0.21).

Conclusion

Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA.

Key points

• CT can detect abnormal first-pass and delayed enhancement in cardiac amyloidosis.

• Measurement of relative myocardial enhancement between acquisitions helps to detect cardiac amyloidosis.

• CT may provide useful data to diagnose cardiac amyloidosis.

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Abbreviations

CA:

Cardiac amyloidosis

CNR:

Contrast-to-noise ratio

CT:

Computed tomography

LGE:

Late gadolinium enhancement

MDCT:

Multidetector computed tomography

RAI:

Relative attenuation index

SNR:

Signal-to-noise ratio

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Acknowledgements

The scientific guarantor of this publication is Jean-François Deux. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Cardiac MR Unit, Radiology Department, Henri Mondor Hospital, University Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, 51 av Mal de Lattre de Tassigny, 94000, Créteil, France

    Jean-François Deux, Cristian-Ionut Mihalache, François Legou, Julie Mayer, Alain Luciani, Hicham Kobeiter & Alain Rahmouni

  2. CNRS EAC 4396, Centre de Recherches Chirurgicales, Henri Mondor Hospital, University Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Créteil, France

    Jean-François Deux

  3. Réseau Amylose Mondorien, Henri Mondor Hospital, Créteil, France

    Jean-François Deux, Thibaud Damy, Julie Mayer, Stéphane Rappeneau & Violaine Planté-Bordeneuve

  4. Cardiology Department, Henri Mondor Hospital, University Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Créteil, France

    Thibaud Damy

  5. Department of Neurophysiology of Neurology, Henri Mondor Hospital, University Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Créteil, France

    Violaine Planté-Bordeneuve

Authors
  1. Jean-François Deux
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  2. Cristian-Ionut Mihalache
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  3. François Legou
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  4. Thibaud Damy
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  5. Julie Mayer
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  6. Stéphane Rappeneau
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  7. Violaine Planté-Bordeneuve
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  8. Alain Luciani
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  9. Hicham Kobeiter
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  10. Alain Rahmouni
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Corresponding author

Correspondence to Jean-François Deux.

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Deux, JF., Mihalache, CI., Legou, F. et al. Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study. Eur Radiol 25, 2291–2297 (2015). https://doi.org/10.1007/s00330-015-3642-2

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  • DOI: https://doi.org/10.1007/s00330-015-3642-2

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