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

ABSTRACT

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 [99m]TC-sestamibi for detection of myocardial viability. 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. 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-MR I and 24 ce-MRI viable segments were described as non-viable by SPECT. SPECT was comparable to ce-MRI for myocardial viability assessment, but we were not able to define which of them was superior