Eur Radiol (2009) 19: 290–297
DOI 10.1007/s00330-008-1150-3
CARDIAC
Andreas H. Mahnken
Gregor Jost
Philipp Bruners
Martin Sieber
Peter R. Seidensticker
Rolf W. Günther
Hubertus Pietsch
Received: 5 May 2008
Revised: 17 July 2008
Accepted: 24 July 2008
Published online: 27 August 2008
# European Society of Radiology 2008
Multidetector computed tomography (MDCT)
evaluation of myocardial viability:
intraindividual comparison of monomeric vs.
dimeric contrast media in a rabbit model
Abstract To evaluate the influence of
different types of iodinated contrast
media on the assessment of myocar-
dial viability, acute myocardial in-
farction (MI) was surgically induced
in six rabbits. Over a period of 45 min,
contrast-enhanced cardiac MDCT
(64×0.6 mm, 80 kV, 680mAs
eff.
) was
repeatedly performed using a contrast
medium dose of 600 mg iodine/kg
body weight. Animals received ran-
domized iopromide 300 and iodixanol
320, respectively. Attenuation values
of healthy and infarcted myocardium
were measured. The size of MI was
computed and compared with nitro-
blue tetrazolium (NBT)-stained spec-
imen. The highest attenuation
differences between infarcted and
healthy myocardium occurred during
the arterial phase with 140.0±3.5 HU
and 141.0±2.2 HU for iopromide and
iodixanol, respectively. For iodixanol
the highest attenuation difference on
delayed contrast-enhanced images
was achieved 3 min post injection
(73.5 HU). A slightly higher attenua-
tion difference was observed for
iopromide 6 min after contrast medi-
um injection (82.2 HU), although not
statistically significant (p=0.6437).
Mean infarct volume as measured by
NBT staining was 33.5%±13.6%.
There was an excellent agreement of
infarct sizes among NBT-, iopromide-
and iodixanol-enhanced MDCT with
concordance-correlation coefficients
ranging from ρ
(c)=
0.9928–0.9982.
Iopromide and iodixanol both allow a
reliable assessment of MI with de-
layed contrast-enhanced MDCT.
Keywords Computed tomography
.
MDCT
.
Contrast media
.
Heart
.
Myocardial infarction
Introduction
The potential of contrast-enhanced computed tomography
(CT) for the visualization of myocardial late enhancement
in myocardial infarction (MI) was shown during the late
1970s. For several reasons, this technique was not valued
as a clinical tool at that time. Today, low-dose dobutamine
stress echocardiography, single photon emission computed
tomography (SPECT) with
201
Tl,
18
F-fluorodeoxyglucose
positron emission tomography (FDG-PET) and delayed
contrast-enhanced magnetic resonance (MR) imaging are
routinely used techniques to access myocardial viability
[1]. The latter was proven to reliably detect irreversibly
damaged myocardium [2]. Regional differences in contrast
agent wash-in and wash-out time constants were identified
as the main mechanism of delayed contrast enhancement in
A. H. Mahnken
.
P. Bruners
.
R. W. Günther
Department of Diagnostic Radiology,
RWTH Aachen University,
Aachen, Germany
A. H. Mahnken
.
P. Bruners
Applied Medical Engineering,
Helmholtz Institute,
RWTH Aachen University,
Aachen, Germany
G. Jost
.
M. Sieber
.
P. R. Seidensticker
.
H. Pietsch
Bayer-Schering Pharma AG,
Berlin, Germany
A. H. Mahnken (*)
Department of Diagnostic Radiology,
University Hospital,
RWTH Aachen University,
Pauwelsstrasse 30,
52074 Aachen, Germany
e-mail: mahnken@rad.rwth-aachen.de
Tel.: +49-241-8088332
Fax: +49-241-8082499