Acute myocardial infarction:: Myocardial viability assessment in patients early thereafter -: Comparison of contrast-enhanced MR imaging with resting 201Tl SPECT

PURPOSE: To compare contrast material-enhanced magnetic resonance (MR) imaging with resting thallium 201 ((TI)-T-201) single photon emission computed tomography (SPECT) for predicting myocardial viability in patients early after acute myocardial infarction. MATERIALS AND METHODS: Inversion-recovery contrast-enhanced MR images and resting (TI)-T-201 SPECT images were obtained in 22 patients after acute myocardial infarction. The (TI)-T-201 SPECT images were obtained 4.3 days 0.2 (standard error) after the onset of myocardial infarction. Contrast-enhanced MR imaging was performed 7.9 days +/- 1.6 after (TI)-T-201 SPECT. Transmural extent of hyperenhancement 1 20 on contrast-enhanced MR images and regiona (TI)-T-201 activity were quantitatively analyzed with a 12-segment model. Regional wall thickening on follow-up cine MR images obtained 67 days 17 after contrast-enhanced MR imaging was used as an index for myocardial viability. Statistical analyses were performed with the chi(2) and two-tailed Student t tests. RESULTS: Both contrast-enhanced MR and resting (TI)-T-201 SPECT images showed significant correlations with regional wall thickening on follow-up cine MR images. The sensitivity, specificity, and accuracy of contrast-enhanced MR imaging in the prediction of viable myocardium were significantly higher than those of resting (TI)-T-201 SPECT (98.0% vs 90.3%, P <.01; 75.0% vs 54.4%, P <.05; and 92.0% vs 81.1 %, P <.001, respectively). CONCLUSION: Delayed contrast-enhanced MR imaging can help predict myocardial viability as seen on follow-up cine MR images after acute myocardial infarction, with significantly improved sensitivity, specificity, and accuracy in comparison with those of resting (TI)-T-210 SPECT. (C) RSNA, 2002.