Abstract

Purpose: To evaluate the capability of multislice CT (MSCT) to detect abnormal late enhancement (LE) in the left ventricular (LV) myocardium in myocardial disease, we compared MSCT with cardiac magnetic resonance (CMR) using segment by segment analysis and summarized the merit of performing late phase acquisition of MSCT. Materials and Methods: 79 subjects (61 male, 56.9±15.6 years) with suspected LV myocardial abnormalities (24 hypertrophic cardiomyopathy, 13 dilated cardiomyopathy, 5 cardiac sarcoidosis, 4 cardiac amyloidosis, 3 arrhythmogenic right ventricular cardiomyopathy, and 1 Fabry disease, et al) underwent enhanced MSCT (Aquilion One, or Light Speed Ultra 16) and CMR (Intera Achieva). Images were divided into 8 segments: 6 in the LV and each one in the right ventricle and either right or left atrium for each subject. Results: Among the 632 segments, LE was detected in 127 segments in MSCT, 137 segments in CMR, and 100 segments in both MSCT and CMR. LE was detected in 27 segments in only MSCT, and in 37 segments in only CMR. LE was not detected in 468 segments in either MSCT or CMR. In comparing CT with CMR for detecting LE, the sensitivity, specificity, positive and negative predictive values, and consistency were 73.0, 94.5, 78.7, 92.7 and 89.9%, respectively. Conclusions: The consistency of detection of LE in LV myocardium by MSCT in myocardial disease compared with CMR was 89.9% in spite of poor contrast resolution of CT. MSCT should be used to evaluate LV myocardium in subjects with suspected LV myocardial abnormalities by adding late phase acquisition despite increments of radiation exposure, and even though late phase acquisition is more desirable than pre enhanced scanning.

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