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Contrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study

Myocardial infarcts are routinely detected by nuclear imaging techniques such as single photon emission computed tomography (SPECT) myocardial perfusion imaging. A newly developed technique for infarct detection based on contrast-enhanced cardiovascular magnetic resonance (CMR) has higher spatial re... Full description

Journal Title: The Lancet (British edition) 2003, Vol.361 (9355), p.374-379
Main Author: Wagner, Anja
Other Authors: Mahrholdt, Heiko , Holly, Thomas A , Elliott, Michael D , Regenfus, Matthias , Parker, Michele , Klocke, Francis J , Bonow, Robert O , Kim, Raymond J , Judd, Robert M
Format: Electronic Article Electronic Article
Language: English
Subjects:
NMR
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/12573373
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title: Contrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study
format: Article
creator:
  • Wagner, Anja
  • Mahrholdt, Heiko
  • Holly, Thomas A
  • Elliott, Michael D
  • Regenfus, Matthias
  • Parker, Michele
  • Klocke, Francis J
  • Bonow, Robert O
  • Kim, Raymond J
  • Judd, Robert M
subjects:
  • Abridged Index Medicus
  • Animals
  • Diagnosis
  • Disease Models, Animal
  • Dogs
  • Evaluation
  • Female
  • Heart attack
  • Heart attacks
  • Histocytochemistry - standards
  • Humans
  • Image Enhancement - methods
  • Image Enhancement - standards
  • Least-Squares Analysis
  • Linear Models
  • Magnetic resonance imaging
  • Magnetic Resonance Imaging - methods
  • Magnetic Resonance Imaging - standards
  • Male
  • Medical procedures
  • Middle Aged
  • Myocardial Infarction - diagnosis
  • NMR
  • Nuclear magnetic resonance
  • Physiological aspects
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • SPECT imaging
  • Technetium Tc 99m Sestamibi
  • Thallium Radioisotopes
  • Tomography, Emission-Computed, Single-Photon - methods
  • Tomography, Emission-Computed, Single-Photon - standards
  • Usage
ispartof: The Lancet (British edition), 2003, Vol.361 (9355), p.374-379
description: Myocardial infarcts are routinely detected by nuclear imaging techniques such as single photon emission computed tomography (SPECT) myocardial perfusion imaging. A newly developed technique for infarct detection based on contrast-enhanced cardiovascular magnetic resonance (CMR) has higher spatial resolution than SPECT. We postulated that this technique would detect infarcts missed by SPECT. We did contrast-enhanced CMR and SPECT examinations in 91 patients with suspected or known coronary artery disease. All CMR and SPECT images were scored, using a 14-segment model, for the presence, location, and spatial extent of infarction. To compare each imaging modality to a gold standard, we also acquired contrast-enhanced CMR and SPECT images in 12 dogs with, and three dogs without, myocardial infarction as defined by histochemical staining. In animals, contrast-enhanced CMR and SPECT detected all segments with nearly transmural infarction (>75% transmural extent of the left-ventricular wall). CMR also identified 100 of the 109 segments (92%) with subendocardial infarction (
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleContrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study
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creatorWagner, Anja ; Mahrholdt, Heiko ; Holly, Thomas A ; Elliott, Michael D ; Regenfus, Matthias ; Parker, Michele ; Klocke, Francis J ; Bonow, Robert O ; Kim, Raymond J ; Judd, Robert M
creatorcontribWagner, Anja ; Mahrholdt, Heiko ; Holly, Thomas A ; Elliott, Michael D ; Regenfus, Matthias ; Parker, Michele ; Klocke, Francis J ; Bonow, Robert O ; Kim, Raymond J ; Judd, Robert M
descriptionMyocardial infarcts are routinely detected by nuclear imaging techniques such as single photon emission computed tomography (SPECT) myocardial perfusion imaging. A newly developed technique for infarct detection based on contrast-enhanced cardiovascular magnetic resonance (CMR) has higher spatial resolution than SPECT. We postulated that this technique would detect infarcts missed by SPECT. We did contrast-enhanced CMR and SPECT examinations in 91 patients with suspected or known coronary artery disease. All CMR and SPECT images were scored, using a 14-segment model, for the presence, location, and spatial extent of infarction. To compare each imaging modality to a gold standard, we also acquired contrast-enhanced CMR and SPECT images in 12 dogs with, and three dogs without, myocardial infarction as defined by histochemical staining. In animals, contrast-enhanced CMR and SPECT detected all segments with nearly transmural infarction (>75% transmural extent of the left-ventricular wall). CMR also identified 100 of the 109 segments (92%) with subendocardial infarction (<50% transmural extent of the left-ventricular wall), whereas SPECT identified only 31 (28%). SPECT and CMR showed high specificity for the detection of infarction (97% and 98%, respectively). In patients, all segments with nearly transmural infarction, as defined by contrast-enhanced CMR, were detected by SPECT. However, of the 181 segments with subendocardial infarction, 85 (47%) were not detected by SPECT. On a per patient basis, six (13%) individuals with subendocardial infarcts visible by CMR had no evidence of infarction by SPECT. SPECT and CMR detect transmural myocardial infarcts at similar rates. However, CMR systematically detects subendocardial infarcts that are missed by SPECT.
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subjectAbridged Index Medicus ; Animals ; Diagnosis ; Disease Models, Animal ; Dogs ; Evaluation ; Female ; Heart attack ; Heart attacks ; Histocytochemistry - standards ; Humans ; Image Enhancement - methods ; Image Enhancement - standards ; Least-Squares Analysis ; Linear Models ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Imaging - standards ; Male ; Medical procedures ; Middle Aged ; Myocardial Infarction - diagnosis ; NMR ; Nuclear magnetic resonance ; Physiological aspects ; Radiopharmaceuticals ; Sensitivity and Specificity ; SPECT imaging ; Technetium Tc 99m Sestamibi ; Thallium Radioisotopes ; Tomography, Emission-Computed, Single-Photon - methods ; Tomography, Emission-Computed, Single-Photon - standards ; Usage
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6Klocke, Francis J
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8Kim, Raymond J
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descriptionMyocardial infarcts are routinely detected by nuclear imaging techniques such as single photon emission computed tomography (SPECT) myocardial perfusion imaging. A newly developed technique for infarct detection based on contrast-enhanced cardiovascular magnetic resonance (CMR) has higher spatial resolution than SPECT. We postulated that this technique would detect infarcts missed by SPECT. We did contrast-enhanced CMR and SPECT examinations in 91 patients with suspected or known coronary artery disease. All CMR and SPECT images were scored, using a 14-segment model, for the presence, location, and spatial extent of infarction. To compare each imaging modality to a gold standard, we also acquired contrast-enhanced CMR and SPECT images in 12 dogs with, and three dogs without, myocardial infarction as defined by histochemical staining. In animals, contrast-enhanced CMR and SPECT detected all segments with nearly transmural infarction (>75% transmural extent of the left-ventricular wall). CMR also identified 100 of the 109 segments (92%) with subendocardial infarction (<50% transmural extent of the left-ventricular wall), whereas SPECT identified only 31 (28%). SPECT and CMR showed high specificity for the detection of infarction (97% and 98%, respectively). In patients, all segments with nearly transmural infarction, as defined by contrast-enhanced CMR, were detected by SPECT. However, of the 181 segments with subendocardial infarction, 85 (47%) were not detected by SPECT. On a per patient basis, six (13%) individuals with subendocardial infarcts visible by CMR had no evidence of infarction by SPECT. SPECT and CMR detect transmural myocardial infarcts at similar rates. However, CMR systematically detects subendocardial infarcts that are missed by SPECT.
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26Sensitivity and Specificity
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28Technetium Tc 99m Sestamibi
29Thallium Radioisotopes
30Tomography, Emission-Computed, Single-Photon - methods
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titleContrast-enhanced MRI and routine single photon emission computed tomography (SPECT) perfusion imaging for detection of subendocardial myocardial infarcts: an imaging study
authorWagner, Anja ; Mahrholdt, Heiko ; Holly, Thomas A ; Elliott, Michael D ; Regenfus, Matthias ; Parker, Michele ; Klocke, Francis J ; Bonow, Robert O ; Kim, Raymond J ; Judd, Robert M
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29Thallium Radioisotopes
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abstractMyocardial infarcts are routinely detected by nuclear imaging techniques such as single photon emission computed tomography (SPECT) myocardial perfusion imaging. A newly developed technique for infarct detection based on contrast-enhanced cardiovascular magnetic resonance (CMR) has higher spatial resolution than SPECT. We postulated that this technique would detect infarcts missed by SPECT. We did contrast-enhanced CMR and SPECT examinations in 91 patients with suspected or known coronary artery disease. All CMR and SPECT images were scored, using a 14-segment model, for the presence, location, and spatial extent of infarction. To compare each imaging modality to a gold standard, we also acquired contrast-enhanced CMR and SPECT images in 12 dogs with, and three dogs without, myocardial infarction as defined by histochemical staining. In animals, contrast-enhanced CMR and SPECT detected all segments with nearly transmural infarction (>75% transmural extent of the left-ventricular wall). CMR also identified 100 of the 109 segments (92%) with subendocardial infarction (<50% transmural extent of the left-ventricular wall), whereas SPECT identified only 31 (28%). SPECT and CMR showed high specificity for the detection of infarction (97% and 98%, respectively). In patients, all segments with nearly transmural infarction, as defined by contrast-enhanced CMR, were detected by SPECT. However, of the 181 segments with subendocardial infarction, 85 (47%) were not detected by SPECT. On a per patient basis, six (13%) individuals with subendocardial infarcts visible by CMR had no evidence of infarction by SPECT. SPECT and CMR detect transmural myocardial infarcts at similar rates. However, CMR systematically detects subendocardial infarcts that are missed by SPECT.
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pmid12573373
doi10.1016/S0140-6736(03)12389-6