Dados do Trabalho

Título

Role of Dual Energy CT in the identification of myocardial infarcts

Descrição sucinta do(s) objetivo(s)

To explore the ability of dual energy delayed enhancement CT (CTDE) to detect myocardial infarcts among stable patients.

Material(is) e método(s)

Our population comprised patients with documented previous myocardial infarction (n= 18) who underwent DECT and DE-CMR, and patients with known or suspected CAD clinically referred for myocardial perfusion imaging by single-photon emission computed tomography (SPECT) (n= 50).
All patients were scanned on a single-source DECT scanner using rapid kV switching (0.3–0.5 ms) between low (80 kV) and high (140 kV) tube potentials (Discovery HD 750, GE Healthcare) to enable the reconstruction of low- and high-energy projections and the generation of Virtual Monochromatic Images reconstructions in 10-keV increments ranging from 40 to 140 keV. Iterative reconstruction was applied at 40% adaptive statistical iterative reconstruction (ASiR 60, GE Healthcare).

Resultados e discussão

In the 68 patients studied the majority were male. 35% had evidence of MI in the reference study. Results per segment show a moderate Sensitivity of 63% and PPV of 77% with good specificity and NPV of 95% and 90% respectively.
There was a systematical less number of compromised segments identified in CT (median 2,5 seg) than in MR (4 segm) . A chronic infart with DECT was better identified at lower energy levels.
The mean HU in the necrotic core at 40 kev was 228+/-42.1 hu whereas the normal myocardium was137+/-30.1 HU.

Conclusões

DECT allowed an accurate detection of MI on a per territory basis among stable patients, although it systematically underestimated the number of segments with delayed enhancement.
This application of DECT might offer an alternative among patients with contraindications for MRI.

Palavras Chave

Dual EnergyCT; myocardial infarcts; Cardiovascular diseases

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