Myocardial Delayed Enhancement CT Versus Late Gadolinium MRI

Myocardial delayed enhancement CT can accurately detect and localize scarring in patients with heart failure when compared with late gadolinium enhancement MRI, according to a study published in the journal Radiology.

Researchers from Japan sought to determine the diagnostic performance of dual-energy CT with myocardial delayed enhancement (MDE) in the detection and classification of myocardial scar in patients with heart failure, with late gadolinium enhancement (LGE) MRI as the standard of reference.

Forty-four patients with heart failure, mean age 66 years, participated in the study. Thirty were men. All underwent MDE CT and LGE MRI and images were retrospectively analyzed.

Two independent readers assessed the presence and patterns of MDE on iodine-density and virtual monochromatic (VM) images.

The results showed that 35 of the 44 patients (80 percent) demonstrated a focal area of LGE, with a nonischemic pattern in 22 of the 44 patients (50 percent) and an ischemic pattern in 13 (30 percent). Iodine-density images demonstrated the highest CNR and percentage signal intensity increase on CT, resulting in the highest diagnostic performance in the detection of any MDE CT abnormality. The areas under the receiver operating characteristic curve for iodine-density images and 40-keV VM images in the detection of MDE were 0.97 and 0.95, respectively.

The researchers concluded that myocardial delayed enhancement CT enabled accurate detection and localization of scar in patients with heart failure when compared with late gadolinium enhancement MRI, the reference standard.