Agreement and disagreement between contrast-enhanced magnetic resonance imaging and nuclear imaging for assessment of myocardial viability |
| |
| Authors: | Stijntje D Roes Theodorus A M Kaandorp Nina Ajmone Marsan Jos J M Westenberg Petra Dibbets-Schneider Marcel P Stokkel Hildo J Lamb Ernst E van der Wall Albert de Roos Jeroen J Bax |
| |
| Institution: | (1) Department of Radiology, Leiden University Medical Center, P.O. Box 9600 Leiden, The Netherlands;(2) Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands;(3) Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands |
| |
| Abstract: | Purpose The purpose of this study was to compare contrast-enhanced MRI and nuclear imaging with 99mTc-tetrofosmin and 18F-fluorodeoxyglucose (18F-FDG) single photon emission computed tomography (SPECT) for assessment of myocardial viability.
Methods Included in the study were 60 patients with severe ischaemic left ventricular (LV) dysfunction who underwent contrast-enhanced
MRI, 99mTc-tetrofosmin and 18F-FDG SPECT. Myocardial segments were assigned a wall motion score from 0 (normokinesia) to 4 (dyskinesia) and a scar score
from 0 (no scar) to 4 (76–100% transmural extent). Furthermore, 99mTc-tetrofosmin and 18F-FDG segmental tracer uptake was categorized from 0 (tracer activity >75%) to 3 (tracer activity <25%). Dysfunctional segments
were classified into viability patterns on SPECT: normal perfusion/18F-FDG uptake, perfusion/18F-FDG mismatch, and mild or severe perfusion/18F-FDG match.
Results Minimal scar tissue was observed on contrast-enhanced MRI (scar score 0.4±0.8) in segments with normal perfusion/18F-FDG uptake, whereas extensive scar tissue (scar score 3.1±1.0) was noted in segments with severe perfusion/18F-FDG match (p < 0.001). High agreement (91%) for viability assessment between contrast-enhanced MRI and nuclear imaging was observed in
segments without scar tissue on contrast-enhanced MRI as well as in segments with transmural scar tissue (83%). Of interest,
disagreement was observed in segments with subendocardial scar tissue on contrast-enhanced MRI.
Conclusion Agreement between contrast-enhanced MRI and nuclear imaging for assessment of viability was high in segments without scar
tissue and in segments with transmural scar tissue on contrast-enhanced MRI. However, evident disagreement was observed in
segments with subendocardial scar tissue on contrast-enhanced MRI, illustrating that the nonenhanced epicardial rim can contain
either normal or ischaemically jeopardized myocardium. |
| |
| Keywords: | Cardiology MRI Myocardial perfusion SPECT 18F-Fluorodeoxyglucose |
| 本文献已被 SpringerLink 等数据库收录！ |
|
