Multidetector CT Measurement of Myocardial Extracellular Volume in Acute Patchy and Contiguous Infarction: Validation with Microscopic Measurement

Abstract

Contrast-enhanced multidetector CT is a suitable noninvasive imaging technique for assessing MECV in acute patchy and contiguous infarct caused by obstruction of major and minor coronary vessels.

Myocardial Extracellular Volume Fraction with Dual-Energy Equilibrium Contrast-enhanced Cardiac CT in Nonischemic Cardiomyopathy: A Prospective Comparison with Cardiac MR Imaging

“…On the basis of these observations, a few studies have been published concerning the measurement of myocardial ECV with pre-and postcontrast equilibrium cardiac CT (11)(12)(13)(14). However, differentiating between myocardium and blood can be difficult on precontrast CT images.…”

“…However, with this protocol, the delay time was too long at 25 minutes. Other investigators, with their protocol of a bolus injection and 10-minute delay time, also showed that cardiac CT might be a suitable noninvasive imaging technique for myocardial ECV in comparison with cardiac MR imaging or myocardial histology results (11,14). With these results, we can optimize the contrast-enhanced protocol toward a more convenient method, which can also include coronary CT angiography.…”

“…Although a few studies about myocardial ECV on cardiac CT images have been published (11)(12)(13)(14), a method involving both unenhanced (precontrast) and contrast-enhanced (postcontrast) CT is thought to be of limited use, because the myocardium and blood might not be easily differentiated on precontrast CT images, and misregistration between the pre-and postcontrast CT images might reduce accuracy.…”

Coronary Embolization and Myocardial Microinfarction: MR Imaging and Histopathologic Characterization

“…With the improvements in spatial and temporal resolution sand reduction in radiation exposure, MDCT has evolved into major clinical noninvasive coronary artery imaging modality. MDCT has been used for visualizing microinfarct and detecting LV dysfunction in embolized myocardium in beating swine heart model [41] [58]- [60].…”

“…Iodinated contrast media for MDCT have extracellular distribution, thus theoretically, their kinetics is parallels to those of gadolinium chelates. On the basis of this hypothesis Jablonowski et al [60] assessed myocardial extracellular volumes in normal myocardium, contiguous infarct and patchy microinfarct. They found that the fractional distribution volume was 24% in viable myocardium, 36% in microinfarct after delivery of 16 mm 3 microemboli, 41% in microinfarct after delivery of 32 mm 3 , 55% in large infarct after 90 min LAD occlusion/revascularization and 56% after 90 min LAD occlusion/revascularization with delivery of 32-mm 3 microemboli.…”