Characterization of Acute and Chronic Myocardial Infarcts by Multidetector Computed Tomography

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Abstract
Background— We evaluated whether contrast-enhanced multidetector computed tomography (CE-MDCT) might characterize myocardial infarct (MI) with patterns similar to those obtained by contrast-enhanced magnetic resonance (CE-MR) and studied the underlying mechanisms. Methods and Results— In vivo infarct characterization by CE-MDCT was shown to be feasible between 4 and 20 minutes after contrast injection in 7 pigs with MI. Subsequently, in 16 patients with acute MI and 21 patients with chronic MI, contrast patterns by CE-MDCT were related to CE-MR. Eighteen patients had hypoenhanced regions on early CE-MDCT images at the time of coronary imaging, and 34 patients had hyperenhanced regions on images acquired 10 minutes later. On a segmental basis, there was moderately good concordance of early hypoenhanced regions (92%, κ=0.54, P<0.001) and late hyperenhanced regions (82%, κ=0.61, P<0.001) between CE-MDCT and CE-MR. Absolute sizes of early hypoenhanced (6±16 versus 7±16 g, P=0.25) and late hyperenhanced (36±34...

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