Evaluation of chronic ischemic heart disease with myocardial perfusion and regional contraction analysis by contrast-enhanced 256-MSCT

Jpn J Radiol. 2013 Feb;31(2):123-32. doi: 10.1007/s11604-012-0159-3. Epub 2012 Nov 20.


Purpose: To investigate myocardial viability in chronic ischemic heart disease by myocardial perfusion and regional contraction analysis using 256-slice MSCT coronary angiography (CCTA).

Methods: In 30 patients with prior myocardial infarction (MI), CCTA with retrospective ECG-gating and stress-redistribution thallium-201 SPECT were performed. Using the same raw data as used for CCTA, myocardial perfusion imaging (CT-MPI) was reconstructed at four phases during the cardiac cycle. Mean myocardial attenuation and wall thickness at end-systole and end-diastole were measured in the MI areas depicted by SPECT, and they were compared between viable and non-viable segments categorized by SPECT.

Results: End-systolic thickness was significantly greater for viable than for non-viable segments (12.0 ± 3.2 vs. 9.6 ± 3.5 mm, p = 0.0017). There was no difference in end-diastolic thickness. Myocardial attenuation was significantly higher for viable than for non-viable segments in the subendocardium (62 ± 13 vs. 70 ± 11 HU, p = 0.003) and the epicardium (65 ± 13 vs. 80 ± 15 HU, p = 0.0002).

Conclusion: The systolic wall thinning and epicardial low-attenuation areas were the indicative findings of CT-MPI for non-viable segments in the prior MI.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Contrast Media
  • Coronary Angiography / methods*
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Iopamidol
  • Male
  • Middle Aged
  • Myocardial Contraction
  • Myocardial Ischemia / diagnosis*
  • Myocardial Perfusion Imaging / methods*
  • Radiographic Image Enhancement / methods
  • Reproducibility of Results
  • Tomography, Emission-Computed, Single-Photon / methods
  • Tomography, X-Ray Computed / methods*


  • Contrast Media
  • Iopamidol