Multislice computed tomography (MSCT) for evaluation of myocardial viability
Iodinated contrast used for CT scanning accumulate in infarcted myocardium similar to what happens with late gadolinium enhanced (LGE) magnetic resonance imaging (MRI). With the high spatial resolution inherent to MSCT (also called multi detector CT or MDCT), differentiation of transmural and subendocardial infarction is possible. Old infarcts have lower density on CT compared to recent infarcts. In general, there is good agreement between LGE MRI and late enhancement noted on MSCT.
In a comparison with dobutamine stress echocardiography, MSCT with 64 multislice CT findings agreed with stress echo findings in 97.3% of the myocardial segments analysed . Disagreement was noted only in 2.7% of the segments.
Overall, MSCT has not become as popular as echo, CMR, Tc99 sestamibi and PET for the assessment of myocardial viability. MSCT has higher radiation exposure than the other modalities and it does have a potential risk of contrast induced acute kidney injury .
Veselova TN et al. Comparison of multislice spiral computed tomography and stress echocardiography in the evaluation of myocardial viability in patients with acute myocardial infarction. Vestn Rentgenol Radiol. 2011 Sep-Oct;(4):24-30.
Souibri K et al. Is multislice computed tomography of value for the imaging of myocardial infarction? Future Cardiol. 2006 Jan;2(1):33-5.