ArticleThe international journal of cardiovascular imaging2026
Qualitative and quantitative evaluation of microvascular obstruction with delayed enhancement cardiac computed tomography in patients with ST-segment elevation myocardial infarction.
Article in The international journal of cardiovascular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We aimed to evaluate the capability of delayed enhancement cardiac computed tomography (DE-CT) for the qualitative and quantitative assessments of microvascular obstruction (MVO) in patients with ST-segment elevation myocardial infarction (STEMI) compared with late gadolinium enhancement magnetic resonance imaging (LGE-MRI). We compared DE-CT and LGE-MRI in patients with STEMI who underwent primary percutaneous coronary intervention (PCI) for a de novo lesion. Short-axis images from both modalities were used to measure hyper-enhanced areas (representing infarcted myocardium) and hypo-enhanced areas within the hyper-enhanced regions (representing MVO). These areas were summated for volumetric analyses. Twenty-two patients with STEMI underwent both DE-CT and LGE-MRI a median of eight days after successful primary PCI. MVO was identified in 16 (73%) patients on both DE-CT and LGE-MRI, with excellent agreement between modalities (κ = 0.88, P < 0.001). Quantitatively, the median infarct volumes were 6475 (1850-14260) mm³ on DE-CT and 5756 (1709-14860) mm³ on LGE-MRI. The median MVO volumes were 706 (437-2737) mm³ on DE-CT and 647 (390-2650) mm³ on LGE-MRI. The correlations between DE-CT and LGE-MRI for infarcted myocardium volume (ρ = 0.976, P < 0.0001) and MVO volume (ρ = 0.926, P < 0.0001) were very strong. DE-CT is a viable alternative to LGE-MRI for both qualitative and quantitative assessments of infarcted myocardium and MVO in patients with STEMI.
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