Purpose: To evaluate the accuracy of 64-section multidetector com-puted tomography (CT) for the assessment of perfusion defects-(PDs), regional wall motion (RWM), and global left ventricular (LV) function.
Materials and Methods: All myocardial infarction (MI) patients signed informed consent. The IRB approved the study and it was HIPAA-compliant. Cardiac multidetector CT was performed in 102 patients (34 with recent acute Ml and 68 without). Multidetector CT images were analyzed for myocardial PD, RWM abnormalities, and LV function. Global LV func-tion and RWM were compared with transthoracic echo-cardiography (TTE) by using multidetector CT. PD was detected by using multidetector CT and was correlated with cardiac biomarkers and single photon emission CT (SPECT) myocardial perfusion imaging. Multidetector CT diagnosis of acute Ml was made on the basis of matching the presence of PD with RWM abnormalities compared with clinical evaluation.
Results: Correlation between multidetector CT and TTE for global function (r = 0.68) and RWM (K = 0.79) was good. The size of PD on multidetector CT had a moderate correlation against SPECT (r = 0.48, -7% ± 9). There was good to excellent correlation between cardiac biomarkers and the percentage infarct size by using multidetector CT (r = 0.82 for creatinine phosphokinase, r = 0.76 for creatinine phosphokinase of the muscle band, and r = 0.75 for tropo-nin). For detection of acute MI in patients, multidetector CT sensitivity was 94% (32 of 34) and specificity was 97% (66 of 68). Multidetector CT had an excellent interob-server reliability for ejection fraction quantification (r - 0.83), as compared with TTE (r = 0.68).
Conclusion: Patients with acute MI can be identified by using multide-tector CT on the basis of RWM abnormalities and PD.