Volume 16 Supplement 1

Abstracts of the 17th Annual SCMR Scientific Sessions

Open Access

Evaluation of accuracy for detection and extent of occult myocardial scars using delayed-enhancement CT in patients with asymptomatic diabetes: results from the ACCREDIT study

  • Joon-Won Kang1,
  • Sang Il Choi2,
  • Sung Min Ko3,
  • Joon Ho Choi1,
  • Yoonyoung Choi1,
  • Jong Chun Park1,
  • So Youn Shin1 and
  • Tae-Hwan Lim1
Journal of Cardiovascular Magnetic Resonance201416(Suppl 1):P87

https://doi.org/10.1186/1532-429X-16-S1-P87

Published: 16 January 2014

Background

Occult myocardial scar is known to be a predictive factor of poor prognosis in the diabetes patients. The purposes of this study are to evaluate through an exploratory sub-study the accuracy of delayed-enhancement CT (DE-CT) for detecting occult myocardial scars (OMS) and to evaluate the transmurality of OMS using DE-CT compared with delayed enhancement MRI (DE-MRI) in asymptomatic patients with type 2 diabetes.

Methods

In this prospective, multicenter, and open-label study, 347 patients with type 2 DM were included with 2 or more risk factors of coronary artery disease. DE-MRI and DE-CT were respectively performed with Gadoterate Meglumine (Dotarem®) and Iobitridol (Xenetix®350) on 167 patients. Image quality of DE-CT was evaluated using 4-grading system, good, adequate, poor and null. The prevalence and the transmurality of OMS on both DE-MRI and DE-CT at patient level and segment level were evaluated. The sensitivity, specificity, positive and negative predictive values of DE-CT for detecting OMS was evaluated in comparison with DE-MRI both at patient and segment level. The transmurality of OMS in DE-CT and DE-MRI for each scar was assessed in terms of over- or underestimation of DE-CT using six grade system, none, 1-25%, 26-50%, 51-75%, and 76-99%, and 100% at segment level.

Results

The image quality of DE-CT was good and adequate in 165 (98.8%) patients. The OMS was detected in 12 (7.3%) by DE-MRI and 7 (4.3%) by DE-CT of the 164 patients. Of the 2788 segments, OMS was detected in 24 segments on DE-MRI and in 12 segments on DE-CT. The sensitivity of DE-CT for detecting OMS was 58.3% (7 of 12), specificity was 100% (152 of 152), positive predictive value was 100% (7 of 7) and the negative predictive value was 96.8% (152 of 157) at patient level. And, at segment level, the sensitivity, specificity, positive and negative predictive value of DE-CT for detecting OMS were 50% (12 of 24), 100% (2764 of 2764), 100%, and 99.6% respectively. The grade for transmurality of OMS between DE-CT and DE-MRI was matching at segment level in 41.7% (10 of 24), under-evalutaion of transmurality on DE-CT was in 54.2% (13 of 24), and overestimation on DE-CT was 4.2% (1 of 24).

Conclusions

The sensitivity of DE-CT for detecting OMS is moderate, but the specificity is high. Under-evaluation of The transmurality of OMS is common using DE-CT.

Funding

This study is supported by the Guerbet group, France.
Table 1

Agreement table between DE-CT and DE-MRI

DE-MRI/

DE-CT

none

1-25%

25-50%

50-75%

75-99%

100%

OMS(+), no grading

none

2764

5

6

   

1

1-25%

 

5

1

    

25-50%

  

3

    

50-75%

  

1

1

   

75-99%

    

0

  

100%

     

0

 

OMS(+), no grading

      

1

Authors’ Affiliations

(1)
Department of Radiology, Asan Medical Center
(2)
Department of Radiology, Seoul National University Bundang Hospital
(3)
Department of Radiology, Konkuk University Hospital

Copyright

© Kang et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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