Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography

Abstract

The comprehensive cardiac CT examination provides reliable coronary artery and myocardial assessments. MDE-DSCT is a robust alternative method to MDE-CMR in assessing myocardial fibrosis in HCM particularly in patients with pacemakers or other contraindications to CMR.

Late enhanced computed tomography in Hypertrophic Cardiomyopathy enables accurate left-ventricular volumetry

“…The addition of LE to further prognostically relevant volumetric parameters describing LV function and dimensions has been shown to increase knowledge regarding a patient's health, cardiac status, and prognosis [24]. This is the first analysis showing low-contrast leMDCT indicated for the visualization of LE, marking (intra)myocardial fibrosis in HCM [12][13][14][15][16][17][18] or post-ischemic scars in CAD [7][8][9][10][11], to allow for accurate LV volumetry ( Table 2). As known from full-contrast MDCT datasets (acquired during first pass) [23,25], LV-MM can be assessed in close analogy to the current gold standard method -regardless of whether it is performed semiautomatically or manually (Fig.…”

“…LeMDCT was introduced for the demonstration of LE in selected [12][13][14][15][16] and consecutive patients with HCM [17]. LE in HCM was proven to be of prognostic relevance [18].…”

“…The reasons for the varying LV contrast lie in the absolute volume of contrast given (here, as elsewhere, 150 mL [15,18] vs. ≤ 120 mL [12][13][14]). The subgroup with good LV contrast represented patients with significantly lower body weight and BMI than the subgroup with sufficient and borderline contrast (Table 1), and thus this group had received a relatively larger volume of contrast medium.…”

“…In consideration of the prognostic role of fibrosis, and in light of the growing body of validated leMDCT data for LE in HCM [12][13][14][15][16][17][18], leMDCT may gain increasing importance with regard to imaging of fibrosis in the context of cardiovascular risk assessment in affected patients. However, pure detection and quantification of LE may not be as relevant.…”

The Clinical and Echocardiographic Analysis of Noncompaction Cardiomyopathy in Misdiagnosis and Missed Diagnosis

“…However, CMR is expensive, and has many contraindications. The patients who have cardiac pacemaker, metal dentures or those who suffer from claustrophobia and cardiac surgery can't accept CMR examination [36]. What's more, most of the NCC patients have cardiac insufficiency.…”