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Assessment of the myocardium on 2-phase cardiac multidetector computed tomography: does cyclic cardiac contraction influence myocardial attenuation?

Publication ,  Journal Article
Boll, DT; Merkle, EM; Paulson, EK; Hoffmann, MH
Published in: J Comput Assist Tomogr
2008

OBJECTIVE: To analyze changes in attenuation of non-contrast-enhanced and contrast-enhanced myocardium throughout the cardiac cycle and to determine the effect of myocardial location, cardiac phase, and dominant coronary perfusion type on myocardial attenuation to evaluate the impact of contraction-dependent factors on multidetector computed tomography (MDCT) perfusion studies. MATERIAL AND METHODS: Cardiac computed tomography imaging was performed on a 40-row MDCT scanner. Myocardial attenuation was assessed in 50 men during 20 cardiac phases. Ninety myocardial regions of interest were placed in the distribution of the right, left anterior descending, and left circumflex coronary arteries on contrast-enhanced MDCT. In 26 patients, myocardial attenuation was also assessed on non-contrast-enhanced MDCT. Myocardial attenuation was analyzed on isopycnic graphs. Attenuation changes due to myocardial contraction were evaluated on non-contrast-enhanced MDCT. The impact of cyclic perfusion on myocardial enhancement was determined on contrast-enhanced MDCT. Student t test and Pearson correlation were used. The influence of dominant coronary perfusion type, supplying coronary artery, and cardiac phase were evaluated using univariate general linear model analysis. RESULTS: Isopycnic graphs revealed that myocardial contraction during systole led to significant increase in myocardial attenuation on non-contrast-enhanced MDCT [ HU systole = 33.2 vs HU diastole = 29.1, P < 0.001]. Reduction in myocardial perfusion during systole led to decrease in myocardial attenuation in contrast-enhanced MDCT [ HU systole = 92.4 vs HU diastole = 111.9, P < 0.001]. Systolic increase in attenuation due to myocardial contraction was far outweighed by the effects of intramyocardial contrast enhancement (correlation Pearson = 0.941). Dominant coronary perfusion did not lead to significant changes in contrast-enhanced myocardium (P = 0.299). Anatomical location and underlying cardiac phase represented significant factors in myocardial attenuation variation (P < 0.001). CONCLUSION: Myocardial attenuation is influenced by cardiac phase and myocardial location. These factors must be considered when analyzing myocardial perfusion with MDCT.

Duke Scholars

Published In

J Comput Assist Tomogr

DOI

EISSN

1532-3145

Publication Date

2008

Volume

32

Issue

4

Start / End Page

602 / 608

Location

United States

Related Subject Headings

  • Tomography, Spiral Computed
  • Radiographic Image Enhancement
  • Periodicity
  • Nuclear Medicine & Medical Imaging
  • Myocardial Contraction
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Image Processing, Computer-Assisted
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Boll, D. T., Merkle, E. M., Paulson, E. K., & Hoffmann, M. H. (2008). Assessment of the myocardium on 2-phase cardiac multidetector computed tomography: does cyclic cardiac contraction influence myocardial attenuation? J Comput Assist Tomogr, 32(4), 602–608. https://doi.org/10.1097/RCT.0b013e31813e07e3
Boll, Daniel T., Elmar M. Merkle, Erik K. Paulson, and Martin H. Hoffmann. “Assessment of the myocardium on 2-phase cardiac multidetector computed tomography: does cyclic cardiac contraction influence myocardial attenuation?J Comput Assist Tomogr 32, no. 4 (2008): 602–8. https://doi.org/10.1097/RCT.0b013e31813e07e3.
Boll, Daniel T., et al. “Assessment of the myocardium on 2-phase cardiac multidetector computed tomography: does cyclic cardiac contraction influence myocardial attenuation?J Comput Assist Tomogr, vol. 32, no. 4, 2008, pp. 602–08. Pubmed, doi:10.1097/RCT.0b013e31813e07e3.

Published In

J Comput Assist Tomogr

DOI

EISSN

1532-3145

Publication Date

2008

Volume

32

Issue

4

Start / End Page

602 / 608

Location

United States

Related Subject Headings

  • Tomography, Spiral Computed
  • Radiographic Image Enhancement
  • Periodicity
  • Nuclear Medicine & Medical Imaging
  • Myocardial Contraction
  • Monitoring, Physiologic
  • Middle Aged
  • Male
  • Image Processing, Computer-Assisted
  • Humans