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CC BY-NC-ND 4.0 · Indian J Radiol Imaging
DOI: 10.1055/s-0045-1806850
Original Article

Comparison of Dual-Energy CT Derived Myocardial Delayed Enhancement with Magnetic Resonance Imaging in Patients with Cardiomyopathy-Related Heart Failure

Damandeep Singh 
1   Department of Radiology and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Uma Debi
1   Department of Radiology and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Manphool Singhal 
1   Department of Radiology and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Arun Sharma 
1   Department of Radiology and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Saurabh Mehrotra
2   Cardiology Department, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Institutsangaben
Funding None.
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Abstract

Background

Cardiomyopathy (CMP) related heart failure (HF) is a leading cause of disability and death. Using novel cardiac magnetic resonance imaging (CMRI), late gadolinium enhancement (LGE) is detected as an imaging marker of myocardial fibrosis. Over the last few years there is increased percentage of ischemia related heart failure, subjecting patients to invasive catheter angiography for detection of coronary artery disease (CAD). This study evaluates the role of Dual energy cardiac computed tomography (DECT) as a one-step modality to diagnose coronary artery disease and myocardial fibrosis in a single step investigation.

Purpose

The aim of the study is to assess the diagnostic performance of DECT in the evaluation of myocardial delayed enhancement (MDE) with LGE MRI as the standard of reference.

Materials and Methods

Thirty patients of heart failure with reduced ejection fraction (<40%) who were diagnosed with myocardial scar (LGE) on CMRI underwent DECT coronary angiography and delayed scan at 8 to 10 minutes for assessment of MDE, mainly assessing the coronary vascular status and the pattern of MDE detection. The MDE images (virtual monochromatic [VM] and iodine density maps) were compared with the LGE images, with LGE as the gold standard.

Results

The diagnostic accuracy of iodine density map and VM images as compared with LGE in CMRI is 76 and 66%, respectively (p < 0.001). The sensitivity and specificity of virtual monochromatic images as compared with iodine density maps is 86.96 and 100%, respectively, with a kappa value of 0.757 consistent with the statistically significant result.

Conclusion

DECT angiography with MDE is a robust investigation to detect coronary artery disease and myocardial fibrosis in the same sitting with comparable performance when compared with CMRI-derived LGE imaging.

Keywords

heart failure - cardiomyopathy - cardiac magnetic resonance - late gadolinium enhancement - dual energy - myocardial delayed enhancement


Publikationsverlauf

Artikel online veröffentlicht:
08. April 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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