Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions

Rodríguez-Granillo, Gastón A.; Rosales, Miguel A.; Renes, Paola; Franco, Eduardo; Pereyra, Jorge; Gómez, Estela; Lillo, Gustavo De; Degrossi, Elina; Rodríguez, Alfredo E.; McFadden, Eugène

doi:10.1016/j.jcct.2009.12.003

Cited by 17 publications

(15 citation statements)

References 21 publications

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“…Small studies have documented that detection of fat and/or calcification in the free wall of the left ventricle by CT likely represents old MI [12,22,23] (Fig. 3); therefore, areas of chronic LV infarction readily appear as hypoattenuations on CCTA because of fat deposition [11][12][13] and reduced capillary density [14]. Computed tomographic appreciation of myocardial scars suggests that adipose infiltration represents a major step in the postinfarction scaring process.…”

Section: Discussionmentioning

confidence: 99%

“…Areas of chronic left ventricular (LV) infarction can be detected on CCTA as regions of hypoattenuation because of deposition of fibrous or adipose tissue [11][12][13] and reduced capillary density [14] because of microvascular damage. Our study evaluates the accuracy and feasibility of resting single-phase (nondynamic) 64-slice CCTA in detecting the presence of infarction and quantifying the perfusion defect compared with nuclear MPI.…”

Section: Introductionmentioning

confidence: 99%

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Detection and quantification of myocardial perfusion defects by resting single-phase 64-slice cardiac computed tomography angiography compared with SPECT myocardial perfusion imaging

Gupta

Kadakia

Jug

et al. 2013

Coronary Artery Disease

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Detection and quantification of myocardial perfusion defects by resting single-phase 64-slice cardiac computed tomography angiography compared with SPECT myocardial perfusion imaging

Gupta

Kadakia

Jug

et al. 2013

Coronary Artery Disease

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“…Non-contrast CCT for calcium scoring purpose can already detect chronic MI showing hypoattenuating myocardial regions if compared with nuclear myocardial perfusion imaging with a sensitivity of 92% and a specificity of 72% on a per-patient basis (56,57).…”

Section: Imaging Findingsmentioning

confidence: 99%

Infarct characterization using CT

Grutta

Toia

Maffei

et al. 2017

Cardiovasc. Diagn. Ther.

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Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination.Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.

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“…42,43 Cardiac CT can also evaluate for scar tissue due to an occult MI. 44,45 Small pilot studies have documented that the presence of fat and/or calcification in the left ventricular free wall is consistent with MI. MI is characterized by a process of ventricular remodeling, fatty replacement (rarefication), and, in rare cases, calcification.…”

Section: Myocardial Scarmentioning

confidence: 99%

Risk stratification of non-contrast CT beyond the coronary calcium scan

Madaj

Budoff

2012

Journal of Cardiovascular Computed Tomography

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Coronary artery calcification (CAC) is a well-known marker for coronary artery disease and has important prognostic implications. CAC is able to provide clinicians with a reliable source of information related to cardiovascular atherosclerosis, which carries incremental information beyond Framingham risk. However, non-contrast scans of the heart provide additional information beyond the Agatston score. These studies are also able to measure various sources of fat, including intrathoracic (eg, pericardial or epicardial) and hepatic, both of which are thought to be metabolically active and linked to increased incidence of subclinical atherosclerosis as well as increased prevalence of type 2 diabetes. Testing for CAC is also useful in identifying extracoronary sources of calcification. Specifically, aortic valve calcification, mitral annular calcification, and thoracic aortic calcium (TAC) provide additional risk stratification information for cardiovascular events. Finally, scanning for CAC is able to evaluate myocardial scaring due to myocardial infarcts, which may also add incremental prognostic information. To ensure the benefits outweigh the risks of a scanning for CAC for an appropriately selected asymptomatic patient, the full utility of the scan should be realized. This review describes the current state of the art interpretation of non-contrast cardiac CT, which clinically should go well beyond coronary artery Agatston scoring alone.

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Chronic myocardial infarction detection and characterization during coronary artery calcium scoring acquisitions

Cited by 17 publications

References 21 publications

Detection and quantification of myocardial perfusion defects by resting single-phase 64-slice cardiac computed tomography angiography compared with SPECT myocardial perfusion imaging

Detection and quantification of myocardial perfusion defects by resting single-phase 64-slice cardiac computed tomography angiography compared with SPECT myocardial perfusion imaging

Infarct characterization using CT

Risk stratification of non-contrast CT beyond the coronary calcium scan

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