Contrast-enhanced magnetic resonance imaging was superior to SPECT for detecting acute myocardial infarction, with an overall sensitivity of 97% versus 87% (p=0.008).
Observational (n=78)
Does contrast-enhanced magnetic resonance imaging improve the detection of myocardial necrosis compared to single-photon emission computed tomography in patients early after acute myocardial infarction?
CMR is superior to SPECT for detecting myocardial necrosis early after reperfused AMI, particularly for small, non-anterior, and non-Q-wave infarcts.
Tasa de eventos absoluta: 97% vs 87%
valor p: p=0.008
OBJECTIVES This study sought to evaluate the diagnostic value of contrast-enhanced magnetic resonance imaging (CMR) and single-photon emission computed tomography (SPECT) for detection of myocardial necrosis after acute myocardial infarction (AMI). BACKGROUND Single-photon emission computed tomography is widely accepted in the clinical setting for detection and estimation of myocardial infarction. Contrast-enhanced magnetic resonance imaging offers technical advantages and is therefore a promising new method for identification of infarcted tissue. METHODS Seventy-eight patients with AMI were examined by CMR and SPECT 7 days after percutaneous coronary intervention. Contrast-enhanced magnetic resonance imaging and SPECT images were scored for presence and location of infarction using a 17-segment model. Results were compared with the peak troponin T level, electrocardiographic, and angiographic findings. RESULTS Acute myocardial infarction was detected significantly more often by CMR than SPECT (overall sensitivity: 97% vs. 87%; p = 0.008). Sensitivity of CMR was superior to SPECT in detecting small infarction as assessed by the peak troponin T level <3.0 ng/ml (92 vs. 69%; p = 0.03), and infarction in non-anterior location (98% vs. 84%; p = 0.03). Non-Q-wave infarctions were more likely to be detected by CMR (sensitivity 85% vs. 46%; p = 0.06). While CMR offered high sensitivity for detection of AMI irrespective of the infarct-related artery, SPECT was less sensitive, particularly within the left circumflex artery territory. CONCLUSIONS Contrast-enhanced magnetic resonance imaging is superior to SPECT in detecting myocardial necrosis after reperfused AMI because CMR detects small infarcts that were missed by SPECT independent of the infarct location. Thus, CMR is attractive for accurate detection and assessment of the myocardial infarct region in patients early after AMI.
Ibrahim et al. (Sat,) conducted a observational in Acute myocardial infarction (n=78). Contrast-enhanced magnetic resonance imaging (CMR) vs. Single-photon emission computed tomography (SPECT) was evaluated on Detection of acute myocardial infarction (overall sensitivity) (p=0.008). Contrast-enhanced magnetic resonance imaging was superior to SPECT for detecting acute myocardial infarction, with an overall sensitivity of 97% versus 87% (p=0.008).