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Cardiac Imaging |
1 From the Departments of Radiology (K.K., T.H.) and Internal Medicine (S.O., K.M.), Matsusaka Central Hospital, Mie, Japan; and Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan (K.K., H.S., K.T.). From the 2001 RSNA scientific assembly. Received December 28, 2001; revision requested February 28, 2002; revision received April 18; accepted June 28. Address correspondence to K.K. (e-mail: kakuya@clin.medic.mie-u.ac.jp).
PURPOSE: To compare contrast material–enhanced magnetic resonance (MR) imaging with resting thallium 201 (201Tl) single photon emission computed tomography (SPECT) for predicting myocardial viability in patients early after acute myocardial infarction.
MATERIALS AND METHODS: Inversion-recovery contrast-enhanced MR images and resting 201Tl SPECT images were obtained in 22 patients after acute myocardial infarction. The 201Tl SPECT images were obtained 4.3 days ± 0.2 (standard error) after the onset of myocardial infarction. Contrast-enhanced MR imaging was performed 7.9 days ± 1.6 after 201Tl SPECT. Transmural extent of hyperenhancement on contrast-enhanced MR images and regional 201Tl activity were quantitatively analyzed with a 12-segment model. Regional wall thickening on follow-up cine MR images obtained 67 days ± 17 after contrast-enhanced MR imaging was used as an index for myocardial viability. Statistical analyses were performed with the 
2 and two-tailed Student t tests.
RESULTS: Both contrast-enhanced MR and resting 201Tl SPECT images showed significant correlations with regional wall thickening on follow-up cine MR images. The sensitivity, specificity, and accuracy of contrast-enhanced MR imaging in the prediction of viable myocardium were significantly higher than those of resting 201Tl SPECT (98.0% vs 90.3%, P < .01; 75.0% vs 54.4%, P < .05; and 92.0% vs 81.1%, P < .001, respectively).
CONCLUSION: Delayed contrast-enhanced MR imaging can help predict myocardial viability as seen on follow-up cine MR images after acute myocardial infarction, with significantly improved sensitivity, specificity, and accuracy in comparison with those of resting 201Tl SPECT.
© RSNA, 2002
Index terms: Heart, function • Heart, MR, 511.121413, 511.12143 • Heart, SPECT, 511.12162 • Myocardium, infarction, 511.771
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