Assessment of myocardial viability with contrast enhanced magnetic resonance imaging and technetium scintigraphy

Abstract EN

Background : In patients with coronary artery disease (CAD), assessment of viable myocardium has important prognostic implications.

The aim of this study was to compare contrast-enhanced magnetic resonance imaging (ce–MRI) with single–photon emission computed tomography (SPECT), using 99mTC–sestamibi for detection of myocardial viability.

Methods : Twenty-seven patients with coronary artery disease and an ejection fraction (EF) < 40% were enrolled.

For the ce–MRI, the segmental extent of hyperenhancement (SEH) was quantified after the administration of a gadolinium–based contrast agent, and for the SPECT a 4-hour redistribution protocol was used.

For the assessment of EF, we used echocardiography.

Comparison of viability assessment was performed in 1458 segments.

Results : Agreement between two modalities was obtained in 1332 (91.4%) segments, resulting in a kappa value of 0.8.

In 126 segments, we had discordant results.

102 SPECT viable segments were non-viable according to ce–MRI and 24 ce–MRI viable segments were described as non-viable by SPECT.

Conclusions : SPECT was comparable to ce–MRI for myocardial viability assessment, but we were not able to define which of them was superior.