August 1, 2005Radiology
Late Defect on Delayed Contrast-enhanced Multi–Detector Row CT Scans in the Prediction of SPECT Infarct Size after Reperfused Acute Myocardial Infarction: Initial Experience
Key result
Late defect on multi-detector row CT scans predicted residual perfusion SPECT defect and infarct size after successfully reperfused MI with 93% sensitivity, 100% specificity, and 94% accuracy.
Why the study?
Does late defect on delayed contrast-enhanced multi-detector row CT accurately predict SPECT infarct size in patients after reperfused acute myocardial infarction?
Population
34 patients after successful reperfusion of acute myocardial infarction.
Comparison
Dual-phase 16-detector row CT within 3 days +/… vs Single photon emission computed tomography…
Design
Cohort, Blind analysis of images by a radiologist and a cardiologist
Follow-up
6 weeks
Authors
Discussion
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Implication
May support early CT infarct sizing post-reperfused MI; leaves open prospective validation against outcomes.
Study Design
Type
Observational (n=34)
Blinding
Blinded
Structured PICO
Does late defect on delayed contrast-enhanced multi-detector row CT accurately predict SPECT infarct size in patients after reperfused acute myocardial infarction?
P
Population
34 patients (mean age 56, 15% female) evaluated with multi-detector row CT within 3 days of successful reperfusion for acute MI, with SPECT follow-up at 6 weeks.
E
Exposure
Dual-phase 16-detector row CT within 3 days +/- 3 after successful reperfusion, with late acquisition 5 minutes after contrast injection.
C
Comparator
Single photon emission computed tomography (SPECT) images obtained 6 weeks later as the reference standard.
O
Outcome
Accuracy of late defect on multi-detector row CT scans in predicting residual perfusion SPECT defect and infarct size.surrogate
Main Result
Absolute Event Rate: 3.1% vs 2.5%
p-value: p=.2
Late defects on delayed contrast-enhanced multi-detector row CT scans performed shortly after reperfused acute MI accurately predict final infarct size as measured by SPECT at 6 weeks.
Cite This Study
Paul et al. (2005) conducted an observational in Acute myocardial infarction after successful reperfusion (n=34). Multi-detector row computed tomography (CT) vs. Single photon emission computed tomography (SPECT) was evaluated on Mean number of segments with late defects (CT) vs infarct size (SPECT) (p=.2). Late defect on multi-detector row CT scans predicted residual perfusion SPECT defect and infarct size after successfully reperfused MI with 93% sensitivity, 100% specificity, and 94% accuracy.