Abstract

BACKGROUND: A number of studies have compared 64-slice multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for left ventricular (LV) function; however, none were performed in patients with reperfused acute myocardial infarction.
OBJECTIVES: We compared global and regional LV function assessment by 64-slice CT (MDCT) with cardiac magnetic resonance (CMR) after reperfused ST elevation myocardial infarction.
METHODS: Twenty-one patients were scanned after reperfusion with contrast-enhanced CMR and MDCT. Reconstructed short axis images were used to assess global (quantitative assessment of LF end-diastolic volume [LVEDV], end-systolic volume [LVESV], stroke volume [LVSV], ejection fraction [LVEF], and mass, by Simpson's method) and regional cardiac function (qualitative assessment on a 4-point scale [4=normal, 3=hypokinesia, 2=dyskinesia, 1=akinesia]) in a standard 17-segment myocardial model.
RESULTS: We scanned 21 persons (age, 60+/-10 years; 19 men) with CMR and MDCT. Good correlation was observed for all global parameters between MDCT and CMR (LVEF, r=0.90; LVEDV, r=0.91; LVESV, r=0.94; LVSV, r=0.84; LV mass, r=0.91). Interobserver agreement for regional function was excellent (weighted kappa, 0.81). The interobserver agreement for regional function on MDCT and CMR were comparable (weighted kappa of 0.86 and 0.88, respectively). MDCT had a better sensitivity, specificity, positive predictive value, and negative predictive value for akinetic segments on CMR than did hypokinetic segments (71%, 91%, 68%, and 93% versus 84%, 97%, 81%, and 98%, respectively).
CONCLUSION: MDCT provides an accurate and reproducible measurement of regional and global LV function in patients with reperfused acute myocardial infarction.