Comparison of delayed enhancement patterns on multislice computed tomography immediately after coronary angiography and cardiac magnetic resonance imaging in acute myocardial infarction
Comparison of delayed enhancement patterns on multislice computed tomography immediately after coronary angiography and cardiac magnetic resonance imaging in acute myocardial infarction
复制标题
急性心肌梗死冠状动脉造影后立即多层计算机断层扫描与心脏磁共振成像延迟增强模式的比较
作者：
M. Habis;A. Capderou;A. Sigal;S. Ghostine;Saliha Rahal;J. Riou;P. Brenot;C. Angel;J. Paul
目的：最近的实验和有限的临床研究证明了延迟增强多层计算机断层扫描（MSCT）对于评估心肌梗死面积（IS）和透壁性的有用性。本研究的目的是比较急性心肌梗死 (AMI) 情况下冠状动脉造影 (CAG) 后立即的 MSCT 增强模式与第二周随访期间的心脏磁共振 (CMR) 增强模式。方法：26 名因 AMI 入院的患者在 CAG 后立即进行 MSCT 评估，无需再次注射碘。除三人外，其余所有人均进行了再灌注。同样的患者在 10 (SD 4) 天随访时出现延迟增强 CMR 成像。当涉及 >75% 的心肌厚度、心内膜下 (1 − ⩽75%) 或正常（后两者可行）时，心肌增强被认为是透壁的（不可行）。需要两个或多个 >75% 的增强节段来定义患者水平或罪魁祸首动脉水平分析的透壁性。为 17 个左心室节段定义了半定量评分。 IS 是根据这些分数计算的。结果：在分段分析中，与 CMR 相比，MSCT 透壁评估的敏感性、特异性、准确性、阳性和阴性预测值分别为 84%、96%、94%、85% 和 96%。根据患者分析，这些值分别为 90%、80%、88%、95% 和 67%。两种方法评估的 IS 高度相关（r = 0.94，p<0.0001），并且回归线与同一线没有统计学差异。结论：对于 AMI，CAG 后立即进行 MSCT 增强而不需再次注射碘是评估透壁性和 IS 的可靠方法。这个非常早期的评估可能是 CMR 的一个有趣的替代方案。
Objective: Recent experimental and limited clinical studies have demonstrated the usefulness of delayed enhancement multislice computed tomography (MSCT) for assessing myocardial infarct size (IS) and transmurality. The aim of this study is to compare MSCT enhancement patterns immediately after coronary angiography (CAG) in an acute myocardial infarction (AMI) setting with cardiac magnetic resonance (CMR) enhancement during the second week follow-up. Methods: 26 patients admitted for an AMI were evaluated by MSCT immediately after CAG without iodine re-injection. All but three were reperfused. The same patients had delayed enhancement CMR imaging at 10 (SD 4)-day follow-up. Myocardial enhancement was considered transmural (non-viable) when involving >75% of myocardial thickness, subendocardial (1 − ⩽75%) or normal (viable for the two latter). Two or more >75% enhanced segments were required to define transmurality on patient-level or culprit artery-level analysis. A semi-quantitative scale score was defined for the 17 left ventricular segments. IS was computed from these scores. Results: On segment analysis, sensitivity, specificity, accuracy, positive and negative predictive values of MSCT for transmurality assessment were 84%, 96%, 94%, 85% and 96%, respectively, compared to CMR. On patient analysis, these respective values were 90%, 80%, 88%, 95% and 67%. IS assessed by the two methods were highly correlated (r = 0.94, p<0.0001) and the regression line did not statistically differ from the identity line. Conclusion: MSCT enhancement immediately following CAG without iodine re-injection for an AMI is a reliable method for evaluating transmurality and IS. This very early evaluation could be an interesting alternative to CMR.
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影响因子：
37.8
作者：
LIMA, JAC;BECKER, LC;WEISS, JL
通讯作者：
WEISS, JL
影响因子：
37.8
作者：
Wu, KC;Zerhouni, EA;Lima, JAC
通讯作者：
Lima, JAC
影响因子：
158.5
作者：
Kim, RJ;Wu, E;Judd, RM
通讯作者：
Judd, RM
影响因子：
37.8
作者：
Rochitte, CE;Lima, JAC;Melin, JA
通讯作者：
Melin, JA