Myocardial enhancement pattern in patients with acute myocardial infarction on two-phase contrast-enhanced ECG-gated multidetector-row computed tomography

AIM: To evaluate the myocardial enhancement pattern of the left ventricle on two-phase contrast- enhanced electrocardiogram (ECG)-gated muttidetector computed tomography (MDCT) images in patients with acute myocardial infarction (AMI). METHODS: Two-phase contrast-enhanced ECG-gated MDCT examinations were performed in 16 patients with AMI. The presence, location and pattern of myocardial enhancement were evaluated. MDCT findings were compared with the catheter angiographic results. RESULTS: Subendocardiat (n= 9) or transmurat (n= 6) area of early perfusion defects of the myocardiurn was detected in 15 of 16 patients (94%) on earty-phase CT images. Variable delayed myocardial enhancement patterns on late-phase CT images were observed in 12 patients (75%): (1) subendocardiat residual perfusion defect and subepicardiat late enhancement (n=6); (2) transmurat late enhancement (n=1); (3) isolated subendocardial. late enhancement (n=1); and (4) isolated subendocardiat residual perfusion defect (n=2). On catheter angiography, 14 of 15 corresponding coronary arteries showed significant stenosis. CONCLUSION: Variable abnormal myocardial enhancement pattern was seen on two-phase, contrast-enhanced ECGgated MDCT in patients with AMI. Assessment of myocardial attenuation on CT angiography gives additional information of the location and extent of infarction. (c) 2006 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.