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Simultaneous Viability Assessment and Invasive Coronary Angiography Using a Therapeutic CT System in Chronic Myocardial Infarction Patients

 Seongmin Ha  ;  Yeonggul Jang  ;  Byoung Kwon Lee  ;  Youngtaek Hong  ;  Byeong-Keuk Kim  ;  Seil Park  ;  Sun Kook Yoo  ;  Hyuk-Jae Chang 
 YONSEI MEDICAL JOURNAL, Vol.65(5) : 257-264, 2024-05 
Journal Title
Issue Date
Aged ; Coronary Angiography* / methods ; Female ; Humans ; Magnetic Resonance Imaging / methods ; Male ; Middle Aged ; Multidetector Computed Tomography / methods ; Myocardial Infarction* / diagnostic imaging ; Myocardial Infarction* / pathology ; Prospective Studies ; Tomography, X-Ray Computed / methods
Myocardial Infarction ; contrast media ; coronary angiography ; multidetector computed tomography ; myocardial stunning
Purpose: In a preclinical study using a swine myocardial infarction (MI) model, a delayed enhancement (DE)-multi-detector computed tomography (MDCT) scan was performed using a hybrid system alongside diagnostic invasive coronary angiography(ICA) without the additional use of a contrast agent, and demonstrated an excellent correlation in the infarct area compared with histopathologic specimens. In the present investigation, we evaluated the feasibility and diagnostic accuracy of a myocardial viability assessment by DE-MDCT using a hybrid system comprising ICA and MDCT alongside diagnostic ICA without the additional use of a contrast agent.

Materials and Methods: We prospectively enrolled 13 patients (median age: 67 years) with a previous MI (>6 months) scheduled to undergo ICA. All patients underwent cardiac magnetic resonance (CMR) imaging before diagnostic ICA. MDCT viability scans were performed concurrently with diagnostic ICA without the use of additional contrast. The total myocardial scar volume per patient and average transmurality per myocardial segment measured by DE-MDCT were compared with those from DE-CMR.

Results: The DE volume measured by MDCT showed an excellent correlation with the volume measured by CMR (r=0.986, p<0.0001). The transmurality per segment by MDCT was well-correlated with CMR (r=0.900, p<0.0001); the diagnostic performance of MDCT in differentiating non-viable from viable myocardium using a 50% transmurality criterion was good with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 87.5%, 99.5%, 87.5%, 99.5%, and 99.1%, respectively.

Conclusion: The feasibility of the DE-MDCT viability assessment acquired simultaneously with conventional ICA was proven in patients with chronic MI using DE-CMR as the reference standard.
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1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Medical Engineering (의학공학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Park, Se Il(박세일) ORCID logo https://orcid.org/0000-0002-4949-8976
Yoo, Sun Kook(유선국) ORCID logo https://orcid.org/0000-0002-6032-4686
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Hong, Youngtaek(홍영택)
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