Diagnostic Value of Contrast-Enhanced Magnetic Resonance Imaging and Single-Photon Emission Computed Tomography for Detection of Myocardial Necrosis Early After Acute Myocardial Infarction
Tareq Ibrahim, MD*,*,
Hubertus P. Bülow, MD ,
Thomas Hackl, MD,
Mira Hörnke, MD,
Stephan G. Nekolla, PhD,
Martin Breuer, MD*,
Albert Schömig, MD* and
Markus Schwaiger, MD, FACC
* Deutsches Herzzentrum and 1. Medizinische Klinik Rechts der Isar, Technische Universität München, München, Germany
Nuklearmedizinische Klinik und Poliklinik, Technische Universität München, München, Germany.
View larger version (112K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 1 Comparison of CMR and SPECT
(A) Non-transmural enhancement by contrast-enhanced magnetic resonance imaging (CMR) (upper row, arrows) in the anterior and antero-septal region (score 2 to 3) (TrueFISP sequence) with corresponding perfusion defect by single-photon emission computed tomography (SPECT) (lower row, arrows). (B) Transmural enhancement by CMR (upper row, arrows) in the inferior region (score 3 to 4) and non-transmural enhancement in the lateral region (score 2 to 3) (TurboFLASH sequence) with corresponding perfusion defect by SPECT (lower row, arrows).
|
|
View larger version (15K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 2 Detection of AMI by CMR and SPECT
(A) Sensitivity of contrast-enhanced magnetic resonance imaging (CMR) and single-photon emission computed tomography (SPECT) for detection of acute myocardial infarction (AMI) based on the peak troponin T levels (TNT). Groups were defined by peak troponin T level <3.0 ng/ml (n = 26), 3.0 to 6.0 ng/ml (n = 27), and >6.0 ng/ml (n = 25) (*p = 0.03). (B) Detection of AMI in anterior and non-anterior regions by CMR and SPECT (*p = 0.03). (C) Detection of electrocardiogram defined Q-wave and non–Q-wave infarction by CMR and SPECT (p = 0.06). Open bars = CMR; solid bars = SPECT.
|
|
View larger version (105K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 3 Discordant CMR and SPECT Results
Contrast-enhanced magnetic resonance imaging (CMR) enhancement (arrows) in (A) the subendocardium of the basal and mid-lateral wall (score 1), and (B) localized transmural enhancement of the basal inferolateral wall (score 3) with normal single-photon emission computed tomography (SPECT) perfusion imaging (arrows).
|
|
View larger version (9K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 4 Sensitivity of CMR and SPECT for Detection of AMI According to the Infarct-Related Artery
AMI = acute myocardial infarction; CMR = contrast-enhanced magnetic resonance imaging; LAD = left anterior descending coronary artery; LCX = left circumflex artery; RCA = right coronary artery; SPECT = single-photon emission computed tomography. Open bars = CMR; solid bars = SPECT.
|
|
View larger version (87K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 5 Discordant CMR and SPECT Results
Patient with a left anterior descending coronary artery-related anteroseptal infarction within the mid and apical region with non-transmural enhancement by contrast-enhanced magnetic resonance imaging (CMR) (score 2 to 3) and single-photon emission computed tomography perfusion defect (arrows). However, single-photon emission computed tomography (SPECT) additionally displayed a false positive perfusion defect (*) in the inferior wall without corresponding enhancement.
|
|
|
