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Multislice Computed Tomography and Magnetic Resonance Imaging for the Assessment of Reperfused Acute Myocardial Infarction

Timo Baks, MD^_*,, Filippo Cademartiri, MD, PhD^_*,, Amber D. Moelker, MSc^_*, Annick C. Weustink, MD, Robert-Jan van Geuns, MD, PhD^_*,, Nico R. Mollet, MD, PhD^_*,, Gabriel P. Krestin, MD, PhD, Dirk J. Duncker, MD, PhD^_* and Pim J. de Feyter, MD, PhD, FACC^_*,,_*

^_* Department of Cardiology, Thoraxcenter
Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands

View larger version (79K): [in a new window]   Figure 1 Acute reperfused myocardial infarction can be assessed accurately with delayed-enhancement multislice computed tomography (DE-MSCT) and delayed-enhancement magnetic resonance imaging (DE-MRI) compared with postmortem triphenyltetrazolium chloride (TTC) pathology. The left ventricle is shown from base (Slice 1) to apex (Slice 6). The MSCT images represent 1-mm slices compared with the photographed TTC pathology slices and the MRI slices of 8 mm.

View larger version (89K): [in a new window]   Figure 2 In this pig with subendocardial infarction, the transmural differentiation of viable and nonviable myocardium is demonstrated with DE-MSCT in short-axis view (B) and long-axis view (C) with TTC pathology as standard of reference (A).

View larger version (16K): [in a new window]   Figure 3 (A) The relation between infarct size assessed with DE-MSCT, DE-MRI, and postmortem TTC pathology. (B) Bland-Altman analyses show the excellent agreement between infarct size assessed with DE-MSCT, DE-MRI, and postmortem TTC pathology. Abbreviations as in Fig. 1.

View larger version (9K): [in a new window]   Figure 4 Regional wall thickening was significantly reduced in infarcted compared with noninfarcted myocardium.

View larger version (28K): [in a new window]   Figure 5 Mean computerized tomography (CT) attenuation value for infarcted myocardium is significantly higher compared with noninfarcted myocardium. Mean magnetic resonance (MR) signal intensity value of infarcted myocardium is significantly higher compared with noninfarcted myocardium. *p < 0.001 compared with infarcted myocardium. p < 0.001 compared with left ventricular (LV) blood pool.

View larger version (171K): [in a new window]   Figure 6 DE-MSCT provides higher spatial resolution than DE-MRI. Image A represents an 8-mm-thick DE-MRI image, and image B represents the similar slice reconstructed from eight different 1-mm-thick DE-MSCT images. Images on the right represent the eight reconstructed 1-mm-thick slices that together form image B. Abbreviations as in Fig. 1.