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ECG-gated multi-detector row spiral CT in the assessment of myocardial infarction: correlation with non-invasive angiographic findings

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Abstract

Our objective was to retrospectively evaluate the ability of multidetector-row computed tomography (MDCT) to detect previous myocardial infarctions (MIs) and to correlate necrosis with the status of coronary arteries supplying the infarcted territory. After having clinically evaluated 187 patients referred for ECG-gated MDCT of the coronary arteries, 30 previous MIs were identified in 29 patients (9 recent and 21 chronic). MDCT data were evaluated qualitatively and quantitatively by measuring attenuation values and wall thickness within the infarcted region and normal adjacent myocardium. Each MI was also assigned to the distribution territory of a coronary vessel, and morphological data were combined with MDCT angiographic findings. MDCT was able to detect 25/30 MIs showing an overall sensitivity and specificity of 83 and 91%, respectively. Quantitative analysis revealed a statistically significant difference in attenuation values between normal and infarcted regions (38.9±14 HU vs. 104.0±16 HU). Regional wall thinning was observed in chronic MIs (4.1±2 mm vs. 10.5±3.8 mm), and not in patients with recent event (7.9±1.6 mm vs 9.1±4 mm). In 22/25 cases, MDCT angiographic findings showed the presence of suspicious critical lumen narrowing (n=3), previous coronary stenting (n=14) and surgical revascularization (n=5) in the infarct-related coronary. During a single examination, MDCT might provide comprehensive imaging of MI offering a combined morphological and angiographic assessment.

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Authors and Affiliations

  1. Department of Radiological Sciences, University of Rome La Sapienza, V.le Regina Elena 324, 00161, Rome, Italy

    Marco Francone, Iacopo Carbone, Massimiliano Danti, Katia Lanciotti, Mario Cavacece, Carlo Catalano & Roberto Passariello

  2. Department of Cardiovascular and Respiratory Sciences, University of Rome La Sapienza, Rome, Italy

    Francesca Mirabelli

  3. Department of Cardiology, Institute of Heart and Great Vessels “A. Reale”, University of Rome La Sapienza, Rome, Italy

    Carlo Gaudio

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  1. Marco Francone
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Correspondence to Marco Francone.

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Francone, M., Carbone, I., Danti, M. et al. ECG-gated multi-detector row spiral CT in the assessment of myocardial infarction: correlation with non-invasive angiographic findings. Eur Radiol 16, 15–24 (2006). https://doi.org/10.1007/s00330-005-2800-3

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  • DOI: https://doi.org/10.1007/s00330-005-2800-3

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