Abstract:

Objective To determine the value of multislice CT (MSCT) in early comprehensive assessment of acute myocardial infarction (AMI) after interventional therapy. Methods Eighteen patients with AMI undergoing percutaneous coronary intervention (PCI) were selected. All patients received dual-phase MSCT one week after treatment. The distribution and enhancement patterns of early perfusion defect (ED), late enhancement (LE), and residual perfusion defect (RD) on MSCT images were analysed. The infarction volume, left ventricular ejection fraction (LVEF) and ventricular wall segmental motion determined by MSCT were compared with area under the curve of serum creatine phosphokinase (CPK) and LVEF and ventricular wall segmental motion measured by transthoracic echocardiography (TTE). Results Seventeen cases of ED were detected on early phase of scan, and both the sensitivity and specificity were 94% in diagnosis of myocardial infarction. Three enhancement patterns were observed on delayed phase of scan: isolated subendocardial LE, subendocardial RD and subepicardial LE, and subendocardial RD. Infarction volume assessed on delayed phase was significantly correlated with area under the curve of serum CPK （r=0.840）, LVEF determined by MSCT and TTE （r=0.800） and ventricular wall segmental motion disorders measured by TTE and MSCT (r=0.814)(P<0.001 for all). Conclusion Different enhancement pattern can be observed on dual phase MSCT in patients with AMI after PCI. Assessment of myocardial attenuation on MSCT gives additional information of the location and extent of infarction after reperfusion. Cardiac function and wall motion information can be obtained by one MSCT exam, which is well correlated with findings from TTE. MSCT is suitable for comprehensive assessment of AMI.

Key words: multislice CT, imaging, myocardial infarction