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KMID : 0311120100510050683
Yonsei Medical Journal
2010 Volume.51 No. 5 p.683 ~ p.691
Evaluation of Reperfused Myocardial Infarction by Low-Dose Multidetector Computed Tomography Using Prospective Electrocardiography (ECG)-Triggering: Comparison with Magnetic Resonance Imaging
Gweon Hye-Mi

Kim Sang-Jin
Kim Tae-Hoon
Lee Sang-Min
Hong Yoo-Jin
Rim Se-Joong
Hong Bum-Kee
Min Pil-Ki
Yoon Young-Won
Kwon Hyuck-Moon
Abstract
Purpose: To evaluate the potential of prospective electrocardiography (ECG)-gated 64-slice multidetector computed tomography (MDCT) for evaluation of myocardial enhancement, infarct size, and stent patency after percutaneous coronary intervention (PCI) with stenting in patients with myocardial infarction.

Materials and Methods: Seventeen patients who were admitted with acute myocardial infarction were examined with prospective ECG-gated 64-slice cardiac MDCT and magnetic resonance (MR) imaging after reperfusion using PCI with stenting. Cardiac MDCT was performed with two different phases: arterial and delayed phases. We evaluated the stent patency on the arterial phase, and nonviable myocardium on the delayed phase of computed tomography (CT) image, and they were compared with the results from the delayed MR images.

Results: Total mean radiation dose was 7.7 ¡¾ 0.5 mSv on the two phases of CT images. All patients except one showed good patency of the stent at the culprit lesion on the arterial phase CT images. All patients had hyperenhanced area on the delayed phase CT images, which correlated well with those on the delayed phase MR images, with a mean difference of 1.6% (20 ¡¾ 10% vs. 22 ¡¾ 10%, r = 0.935, p = 0.10). Delayed MR images had a better contrast-to-noise ratio (CNR) than delayed CT images (27.1 ¡¾ 17.8% vs. 4.3 ¡¾ 2.1%, p < 0.001).

Conclusion: Prospective ECG-gated 64-slice MDCT provides the potential to evaluate myocardial viability on delayed phase as well as for stent patency on arterial phase with an acceptable radiation dose after PCI with stenting in patients with myocardial infarction.
KEYWORD
Prospective ECG-gated MDCT, magnetic resonance imaging, myocardial infarction, delayed enhancement imaging
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