Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis: A feasibility study

Tadao Aikawa, Noriko Oyama-Manabe, Masanao Naya, Hiroshi Ohira, Ayako Sugimoto, Ichizo Tsujino, Masahiko Obara, Osamu Manabe, Kohsuke Kudo, Hiroyuki Tsutsui, Nagara Tamaki

研究成果: ジャーナルへの寄稿記事

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Objectives: To evaluate the diagnostic value of delayed contrast-enhanced computed tomography (DE-CT) for cardiac sarcoidosis (CS) in patients with or without implantable devices, including a quantitative comparison with late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Methods: Twenty-four patients (mean age, 64 ± 9 years; 17 women) with known or suspected CS underwent retrospective electrocardiogram-gated DE-CT at 80 kV with knowledge-based iterative model reconstruction. Fourteen patients without implantable devices also underwent LGE-CMR, while ten with pacemakers or implantable cardioverter-defibrillators did not. The presence of hyperenhanced myocardium was assessed visually and quantitatively using a 5-standard deviation threshold above the mean of remote myocardium. Results: Inter-observer agreement for visual detection of hyperenhanced segments on DE-CT was excellent in patients with implantable devices and in those without (κ = 0.91 and κ = 0.94, respectively). Comparisons of the percent area of hyperenhanced myocardium between DE-CT and LGE-CMR on both per-patient and per-segment analyses showed good correlations (r = 0.96 and r = 0.83, respectively; p < 0.001). The sensitivity and specificity of DE-CT for the diagnosis of CS were 94% and 33%. Conclusions: The extent of hyperenhanced lesion with DE-CT showed good agreement with LGE-CMR results. DE-CT showed high sensitivity for detecting CS and may be useful particularly in patients with contraindications to CMR. Key Points: • Delayed contrast-enhanced CT (DE-CT) can be applied to patients with implantable devices. • DE-CT can detect cardiac sarcoidosis (CS) lesions similarly to cardiac MRI. • DE-CT shows high sensitivity for detecting CS. • DE-CT may be useful particularly in patients with contraindications to cardiac MRI.

元の言語英語
ページ(範囲)4054-4063
ページ数10
ジャーナルEuropean Radiology
27
発行部数10
DOI
出版物ステータス出版済み - 10 1 2017

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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    Aikawa, T., Oyama-Manabe, N., Naya, M., Ohira, H., Sugimoto, A., Tsujino, I., Obara, M., Manabe, O., Kudo, K., Tsutsui, H., & Tamaki, N. (2017). Delayed contrast-enhanced computed tomography in patients with known or suspected cardiac sarcoidosis: A feasibility study. European Radiology, 27(10), 4054-4063. https://doi.org/10.1007/s00330-017-4824-x