Abstract
Aims and Objectives
The aim of this study was to compare the efficacy of various cardiac magnetic resonance
imaging (MRI) parameters in assessing myocardial viability with positron emission
tomography–computed tomography (PET-CT) as the gold standard.
Materials and Methods
This was a prospective analytical study comprising 28 adult patients with perfusion/metabolism
matched or mismatched defects in PET-CT. These patients were taken up for MR evaluation,
mainly assessing end-diastolic wall thickness (EDWT), regional wall motion abnormalities,
and late gadolinium enhancement (LGE) for infarcted tissue. EDWT was measured manually
and using semiautomatic software, and means were calculated.
Results
Of 448 (28 × 16) myocardial segments, 6% (n = 27) of the segments were considered not viable with matched defect, 56.5% (n = 253) were normal, and 37.5% (n = 168) were hibernating according to PET-CT. 51.1% (n = 86) of the hibernating segments showed no wall motion and 48% (n = 82) showed some wall motion, with a sensitivity of 66.03% (p < 0.001). There is good concordance of motion abnormalities detected using tagging
with LGE. LGE and EDWT showed good sensitivity, 91.7 and 89.5%, respectively, as compared
with PET CT in identifying viable but hibernating myocardium.
Conclusion
MRI parameter shows increased specificity and positive predictive value in identifying
non-viable myocardium compared with PET/CT. All parameters had good sensitivity in
identifying hibernating myocardium but had significantly low specificities.
Clinical relevance Cardiac MRI, when used in combination with PET CT, improves the sensitivity in identifying
the viable but hibernating myocardium.
Keywords
cardiac - gadolinium - myocardium - PET-CT
