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Myocardial viability by contrast-enhanced cardiovascular magnetic resonance in patients with coronary artery disease: comparison with gated single-photon emission tomography and FDG position emission tomography

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Abstract

Background

The aim of this study was to assess the value of contrast-enhanced cardiovascular magnetic resonance (CMR) in viability for patients with coronary artery disease and left ventricular (LV) dysfunction (ejection fraction [EF] ≤50%), comparing to gated thallium-201 (201Tl) single photon emission computed tomography (SPECT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET).

Methods and Results

One hundred sixteen patients (EF 37.8 ± 16.2%) underwent stress-reinjection or rest-redistribution gated-SPECT and CMR (46 FDG-PET) within 1 month. All images were analyzed in a 17-segment and 0–4 scales system. Of 1972 segments, delayed enhancement (DE) on CMR correlated well with 201Tl reduction (r = 0.90, p < 0.0001). The agreement of SPECT (≥50% maximal 201Tl activity) and CMR (≤50% DE) was 96.8% (κ = 0.62). CMR detected more subendocardial scars in 18 subjects (60 segments). Reduced 201Tl activity but none DE were observed in 19 subjects (76 segments; more inferior) who had lower EF and larger end-systolic volume (p < 0.05). Of 411 dysfunctional segments from 46 patients, FDG-PET (≥50% of maximal FDG uptake) detected more viability (9%).

Conclusion

The extent of DE correlated 201Tl activity well. CMR could detect more small infarcts, while FDG-PET could detect more viability. CMR could distinguish between artifacts or infarction on SPECT, especially in poor LV function.

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Acknowledgements

The authors have indicated they have no financial conflicts of interest.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara, Sakyo-ku, Kyoto, 606-8507, Japan

    Yen-Wen Wu, Eiji Tadamura, Shotaro Kanao, Masaki Yamamuro & Kaori Togashi

  2. Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Akira Marui & Masashi Komeda

  3. Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Masanao Toma & Takeshi Kimura

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  1. Yen-Wen Wu
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Correspondence to Eiji Tadamura.

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Wu, YW., Tadamura, E., Kanao, S. et al. Myocardial viability by contrast-enhanced cardiovascular magnetic resonance in patients with coronary artery disease: comparison with gated single-photon emission tomography and FDG position emission tomography. Int J Cardiovasc Imaging 23, 757–765 (2007). https://doi.org/10.1007/s10554-007-9215-y

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