Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study

To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT). Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNRmyoc), blood pool SNR (SNRblood), contrast-to-noise ratio between blood pool and myocardium (CNRblood-myoc) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated. Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNRmyoc of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 +/- 1.9) and higher on delayed acquisition (7.10 +/- 2.7) than control patients (6.1 +/- 2.2 and 5.03 +/- 1.8, respectively). Myocardial attenuation was higher in CA (121 +/- 39 HU) than control patients (81 +/- 17 HU) on delayed acquisition. CNRblood-myoc was significantly (p < 0.05) lower in CA (1.51 +/- 0.7) than control patients (2.85 +/- 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 +/- 0.25) than in control patients (-0.56 +/- 0.21). Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA. aEuro cent CT can detect abnormal first-pass and delayed enhancement in cardiac amyloidosis. aEuro cent Measurement of relative myocardial enhancement between acquisitions helps to detect cardiac amyloidosis. aEuro cent CT may provide useful data to diagnose cardiac amyloidosis.