Skip to main content
Erschienen in: European Radiology 8/2015

01.08.2015 | Cardiac

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

verfasst von: Jean-François Deux, Cristian-Ionut Mihalache, François Legou, Thibaud Damy, Julie Mayer, Stéphane Rappeneau, Violaine Planté-Bordeneuve, Alain Luciani, Hicham Kobeiter, Alain Rahmouni

Erschienen in: European Radiology | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT).

Methods

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.

Results

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).

Conclusion

Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA.

Key points

• CT can detect abnormal first-pass and delayed enhancement in cardiac amyloidosis.
• Measurement of relative myocardial enhancement between acquisitions helps to detect cardiac amyloidosis.
• CT may provide useful data to diagnose cardiac amyloidosis.
Literatur
1.
2.
Zurück zum Zitat Koyama J, Falk RH (2010) Prognostic significance of strain Doppler imaging in light-chain amyloidosis. JACC Cardiovasc Imaging 3:333–342PubMedCrossRef Koyama J, Falk RH (2010) Prognostic significance of strain Doppler imaging in light-chain amyloidosis. JACC Cardiovasc Imaging 3:333–342PubMedCrossRef
3.
Zurück zum Zitat Selvanayagam JB, Hawkins PN, Paul B, Myerson SG, Neubauer S (2007) Evaluation and management of the cardiac amyloidosis. J Am Coll Cardiol 50:2101–2110PubMedCrossRef Selvanayagam JB, Hawkins PN, Paul B, Myerson SG, Neubauer S (2007) Evaluation and management of the cardiac amyloidosis. J Am Coll Cardiol 50:2101–2110PubMedCrossRef
4.
Zurück zum Zitat Austin BA, Tang WH, Rodriguez ER et al (2009) Delayed hyper-enhancement magnetic resonance imaging provides incremental diagnostic and prognostic utility in suspected cardiac amyloidosis. JACC Cardiovasc Imaging 2:1369–1377PubMedCrossRef Austin BA, Tang WH, Rodriguez ER et al (2009) Delayed hyper-enhancement magnetic resonance imaging provides incremental diagnostic and prognostic utility in suspected cardiac amyloidosis. JACC Cardiovasc Imaging 2:1369–1377PubMedCrossRef
5.
Zurück zum Zitat Maceira AM, Joshi J, Prasad SK et al (2005) Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation 111:186–193PubMedCrossRef Maceira AM, Joshi J, Prasad SK et al (2005) Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation 111:186–193PubMedCrossRef
6.
Zurück zum Zitat Maceira AM, Prasad SK, Hawkins PN, Roughton M, Pennell DJ (2008) Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis. J Cardiovasc Magn Reson 10:54PubMedCentralPubMedCrossRef Maceira AM, Prasad SK, Hawkins PN, Roughton M, Pennell DJ (2008) Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis. J Cardiovasc Magn Reson 10:54PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Syed IS, Glockner JF, Feng D et al (2010) Role of cardiac magnetic resonance imaging in the detection of cardiac amyloidosis. JACC Cardiovasc Imaging 3:155–164PubMedCrossRef Syed IS, Glockner JF, Feng D et al (2010) Role of cardiac magnetic resonance imaging in the detection of cardiac amyloidosis. JACC Cardiovasc Imaging 3:155–164PubMedCrossRef
8.
Zurück zum Zitat Vogelsberg H, Mahrholdt H, Deluigi CC et al (2008) Cardiovascular magnetic resonance in clinically suspected cardiac amyloidosis: noninvasive imaging compared to endomyocardial biopsy. J Am Coll Cardiol 51:1022–1030PubMedCrossRef Vogelsberg H, Mahrholdt H, Deluigi CC et al (2008) Cardiovascular magnetic resonance in clinically suspected cardiac amyloidosis: noninvasive imaging compared to endomyocardial biopsy. J Am Coll Cardiol 51:1022–1030PubMedCrossRef
9.
Zurück zum Zitat Mark DB, Berman DS, Budoff MJ et al (2010) ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 55:2663–2699PubMedCrossRef Mark DB, Berman DS, Budoff MJ et al (2010) ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 55:2663–2699PubMedCrossRef
10.
Zurück zum Zitat Montalescot G, Sechtem U, Achenbach S et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003PubMedCrossRef Montalescot G, Sechtem U, Achenbach S et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003PubMedCrossRef
11.
Zurück zum Zitat Baks T, Cademartiri F, Moelker AD et al (2007) Assessment of acute reperfused myocardial infarction with delayed enhancement 64-MDCT. AJR Am J Roentgenol 188:W135–W137PubMedCrossRef Baks T, Cademartiri F, Moelker AD et al (2007) Assessment of acute reperfused myocardial infarction with delayed enhancement 64-MDCT. AJR Am J Roentgenol 188:W135–W137PubMedCrossRef
12.
Zurück zum Zitat Gerber BL, Belge B, Legros GJ et al (2006) Characterization of acute and chronic myocardial infarcts by multidetector computed tomography: comparison with contrast-enhanced magnetic resonance. Circulation 113:823–833PubMedCrossRef Gerber BL, Belge B, Legros GJ et al (2006) Characterization of acute and chronic myocardial infarcts by multidetector computed tomography: comparison with contrast-enhanced magnetic resonance. Circulation 113:823–833PubMedCrossRef
13.
Zurück zum Zitat Nieman K, Shapiro MD, Ferencik M et al (2008) Reperfused myocardial infarction: contrast-enhanced 64-Section CT in comparison to MR imaging. Radiology 247:49–56PubMedCrossRef Nieman K, Shapiro MD, Ferencik M et al (2008) Reperfused myocardial infarction: contrast-enhanced 64-Section CT in comparison to MR imaging. Radiology 247:49–56PubMedCrossRef
14.
Zurück zum Zitat Rodriguez-Granillo GA, Rosales MA, Baum S et al (2009) Early assessment of myocardial viability by the use of delayed enhancement computed tomography after primary percutaneous coronary intervention. JACC Cardiovasc Imaging 2:1072–1081PubMedCrossRef Rodriguez-Granillo GA, Rosales MA, Baum S et al (2009) Early assessment of myocardial viability by the use of delayed enhancement computed tomography after primary percutaneous coronary intervention. JACC Cardiovasc Imaging 2:1072–1081PubMedCrossRef
15.
Zurück zum Zitat Sato A, Nozato T, Hikita H et al (2012) Prognostic value of myocardial contrast delayed enhancement with 64-slice multidetector computed tomography after acute myocardial infarction. J Am Coll Cardiol 59:730–738PubMedCrossRef Sato A, Nozato T, Hikita H et al (2012) Prognostic value of myocardial contrast delayed enhancement with 64-slice multidetector computed tomography after acute myocardial infarction. J Am Coll Cardiol 59:730–738PubMedCrossRef
16.
Zurück zum Zitat Zhao L, Ma X, Delano MC et al (2013) Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography. Eur Radiol 23:1034–1043PubMedCrossRef Zhao L, Ma X, Delano MC et al (2013) Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography. Eur Radiol 23:1034–1043PubMedCrossRef
17.
Zurück zum Zitat Dambrin G, Laissy JP, Serfaty JM, Caussin C, Lancelin B, Paul JF (2007) Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI. Eur Radiol 17:331–338PubMedCrossRef Dambrin G, Laissy JP, Serfaty JM, Caussin C, Lancelin B, Paul JF (2007) Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI. Eur Radiol 17:331–338PubMedCrossRef
18.
Zurück zum Zitat Bandula S, Banypersad SM, Sado D et al (2013) Measurement of tissue interstitial volume in healthy patients and those with amyloidosis with equilibrium contrast-enhanced MR imaging. Radiology 268:858–864PubMedCrossRef Bandula S, Banypersad SM, Sado D et al (2013) Measurement of tissue interstitial volume in healthy patients and those with amyloidosis with equilibrium contrast-enhanced MR imaging. Radiology 268:858–864PubMedCrossRef
19.
Zurück zum Zitat Banypersad SM, Sado DM, Flett AS et al (2013) Quantification of myocardial extracellular volume fraction in systemic AL amyloidosis: an equilibrium contrast cardiovascular magnetic resonance study. Circ Cardiovasc Imaging 6:34–39PubMedCrossRef Banypersad SM, Sado DM, Flett AS et al (2013) Quantification of myocardial extracellular volume fraction in systemic AL amyloidosis: an equilibrium contrast cardiovascular magnetic resonance study. Circ Cardiovasc Imaging 6:34–39PubMedCrossRef
20.
Zurück zum Zitat Canet EP, Janier MF, Revel D (1999) Magnetic resonance perfusion imaging in ischemic heart disease. J Magn Reson Imaging 10:423–433PubMedCrossRef Canet EP, Janier MF, Revel D (1999) Magnetic resonance perfusion imaging in ischemic heart disease. J Magn Reson Imaging 10:423–433PubMedCrossRef
21.
Zurück zum Zitat Weinmann HJ, Brasch RC, Press WR, Wesbey GE (1984) Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. AJR Am J Roentgenol 142:619–624PubMedCrossRef Weinmann HJ, Brasch RC, Press WR, Wesbey GE (1984) Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent. AJR Am J Roentgenol 142:619–624PubMedCrossRef
22.
Zurück zum Zitat Mahrholdt H, Wagner A, Judd RM, Sechtem U, Kim RJ (2005) Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 26:1461–1474PubMedCrossRef Mahrholdt H, Wagner A, Judd RM, Sechtem U, Kim RJ (2005) Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 26:1461–1474PubMedCrossRef
23.
Zurück zum Zitat Bourin M, Jolliet P, Ballereau F (1997) An overview of the clinical pharmacokinetics of x-ray contrast media. Clin Pharmacokinet 32:180–193PubMedCrossRef Bourin M, Jolliet P, Ballereau F (1997) An overview of the clinical pharmacokinetics of x-ray contrast media. Clin Pharmacokinet 32:180–193PubMedCrossRef
24.
Zurück zum Zitat Paul JF, Wartski M, Caussin C et al (2005) Late defect on delayed contrast-enhanced multi-detector row CT scans in the prediction of SPECT infarct size after reperfused acute myocardial infarction: initial experience. Radiology 236:485–489PubMedCrossRef Paul JF, Wartski M, Caussin C et al (2005) Late defect on delayed contrast-enhanced multi-detector row CT scans in the prediction of SPECT infarct size after reperfused acute myocardial infarction: initial experience. Radiology 236:485–489PubMedCrossRef
25.
Zurück zum Zitat Kartje JK, Schmidt B, Bruners P, Mahnken AH (2013) Dual energy CT with nonlinear image blending improves visualization of delayed myocardial contrast enhancement in acute myocardial infarction. Invest Radiol 48:41–45PubMedCrossRef Kartje JK, Schmidt B, Bruners P, Mahnken AH (2013) Dual energy CT with nonlinear image blending improves visualization of delayed myocardial contrast enhancement in acute myocardial infarction. Invest Radiol 48:41–45PubMedCrossRef
Metadaten
Titel
Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study
verfasst von
Jean-François Deux
Cristian-Ionut Mihalache
François Legou
Thibaud Damy
Julie Mayer
Stéphane Rappeneau
Violaine Planté-Bordeneuve
Alain Luciani
Hicham Kobeiter
Alain Rahmouni
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 8/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3642-2

Weitere Artikel der Ausgabe 8/2015

European Radiology 8/2015 Zur Ausgabe

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.