Evaluating global and regional left ventricular function in patients with reperfused acute myocardial infarction by 64-slice multidetector CT: A comparison to magnetic resonance imaging

BackgroundA number of studies have compared 64-slice multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for left ventricular (LV) function; however, none were performed in patients with reperfused acute myocardial infarction.ObjectivesWe compared global and regional LV function assessment by 64-slice CT (MDCT) with cardiac magnetic resonance (CMR) after reperfused ST elevation myocardial infarction.MethodsTwenty-one patients were scanned after reperfusion with contrast-enhanced CMR and MDCT. Reconstructed short axis images were used to assess global (quantitative assessment of LF end-diastolic volume [LVEDV], end-systolic volume [LVESV], stroke volume [LVSV], ejection fraction [LVEF], and mass, by Simpson's method) and regional cardiac function (qualitative assessment on a 4-point scale [4 = normal, 3 = hypokinesia, 2 = dyskinesia, 1 = akinesia]) in a standard 17-segment myocardial model.ResultsWe scanned 21 persons (age, 60 ± 10 years; 19 men) with CMR and MDCT. Good correlation was observed for all global parameters between MDCT and CMR (LVEF, r = 0.90; LVEDV, r = 0.91; LVESV, r = 0.94; LVSV, r = 0.84; LV mass, r = 0.91). Interobserver agreement for regional function was excellent (weighted κ, 0.81). The interobserver agreement for regional function on MDCT and CMR were comparable (weighted κ of 0.86 and 0.88, respectively). MDCT had a better sensitivity, specificity, positive predictive value, and negative predictive value for akinetic segments on CMR than did hypokinetic segments (71%, 91%, 68%, and 93% versus 84%, 97%, 81%, and 98%, respectively).ConclusionMDCT provides an accurate and reproducible measurement of regional and global LV function in patients with reperfused acute myocardial infarction.