Journal of cardiovascular computed tomography · 2026
Diagnostic performance of shuttle-mode myocardial CT late enhancement: Comparison with late gadolinium enhancement cardiovascular MR.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kokawa Takanori, Nakamura Satoshi, Nakamori Shiro, Kurita Tairo, Nagasawa Naoki, Dohi Kaoru, Sakuma Hajime, Kitagawa Kakuya
Аннотация
OBJECTIVES: Although myocardial CT late enhancement (CT-LE) has been reported in various studies, its diagnostic performance using shuttle-mode dual-source CT has not been fully validated for detecting myocardial infarction (MI) and assessing its transmural extent against late gadolinium enhancement cardiovascular MR (LGE-CMR). This study aimed to evaluate the diagnostic performance of shuttle-mode myocardial CT-LE in detecting MI with LGE-CMR as a reference standard.
MATERIALS & METHODS: This study included 56 patients with suspected or known coronary artery disease who underwent both comprehensive cardiac CT, including myocardial CT-LE, and LGE-CMR from a prospective, multicenter trial (AMPLIFiED). Sixteen myocardial segments per patient (excluding the apical cap based on AHA classification) were assessed. Segments were classified as having or not having MI; segments with MI were further categorized by transmural extent: <50%, 50-99%, or 100%. Two observers independently assessed myocardial CT-LE images. LGE-CMR findings were determined by consensus between two observers.
RESULTS: In the segment-based analysis (n = 896), myocardial CT-LE showed a sensitivity of 97.6% and a positive predictive value (PPV) of 93.0%-94.1% for MI detection (specificity, 99.3%-99.4%; negative predictive value [NPV], 99.8%). Agreement for transmural extent was high (weighted kappa, 0.82-0.83). Inter-reader reproducibility for binary MI detection was excellent (agreement, 99.4%; kappa, 0.97). In an exploratory patient-level analysis based on 19 LGE-CMR-positive patients, sensitivity was 94.7% (95% confidence interval [CI], 74.0%-99.9%) for Observer A and 100% (95% CI, 82.4%-100%) for Observer B; the corresponding PPVs were 94.7% and 90.5%.
CONCLUSION: Shuttle-mode myocardial CT-LE demonstrated excellent agreement with LGE-CMR for the detection and transmural assessment of MI. Its high sensitivity for subendocardial MI supports its value as a reliable alternative to LGE-CMR.
MATERIALS & METHODS: This study included 56 patients with suspected or known coronary artery disease who underwent both comprehensive cardiac CT, including myocardial CT-LE, and LGE-CMR from a prospective, multicenter trial (AMPLIFiED). Sixteen myocardial segments per patient (excluding the apical cap based on AHA classification) were assessed. Segments were classified as having or not having MI; segments with MI were further categorized by transmural extent: <50%, 50-99%, or 100%. Two observers independently assessed myocardial CT-LE images. LGE-CMR findings were determined by consensus between two observers.
RESULTS: In the segment-based analysis (n = 896), myocardial CT-LE showed a sensitivity of 97.6% and a positive predictive value (PPV) of 93.0%-94.1% for MI detection (specificity, 99.3%-99.4%; negative predictive value [NPV], 99.8%). Agreement for transmural extent was high (weighted kappa, 0.82-0.83). Inter-reader reproducibility for binary MI detection was excellent (agreement, 99.4%; kappa, 0.97). In an exploratory patient-level analysis based on 19 LGE-CMR-positive patients, sensitivity was 94.7% (95% confidence interval [CI], 74.0%-99.9%) for Observer A and 100% (95% CI, 82.4%-100%) for Observer B; the corresponding PPVs were 94.7% and 90.5%.
CONCLUSION: Shuttle-mode myocardial CT-LE demonstrated excellent agreement with LGE-CMR for the detection and transmural assessment of MI. Its high sensitivity for subendocardial MI supports its value as a reliable alternative to LGE-CMR.