Automated multidetector computed tomography evaluation of subacutely infarcted myocardium

Balázs Ruzsics, Pál Surányi, Pál Kiss, Brigitta C. Brott, Satinder S. Singh, Silvio Litovsky, Inmaculada Aban, Steven G. Lloyd, Tamas Simor, Gabriel A. Elgavish, Himanshu Gupta

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7 Citations (Scopus)


Background: Delayed enhanced (DE) multidetector computed tomography (MDCT) can identify acute and chronic myocardial infarct. To our knowledge, automated techniques for infarct quantification on DE-MDCT have not been used. Objective: We evaluated an automated signal intensity (SI) threshold method for quantification of subacute myocardial infarct and identified and quantified microvascular obstruction (MO) in subacute infarct. Methods: DE-MDCT imaging was performed on 5 pigs 6-7 days after mid left anterior descending artery occlusion-reperfusion. DE-MDCT images were compared with triphenyl tetrazolium chloride (TTC) staining for infarct quantification and with hematoxylin and eosin (H&E) staining for MO quantification. Pixels with SI more than the mean SI of a remote normal myocardial region (SIremote) plus 2 times the standard deviation (SIremote + 2 SD) value were considered infarct pixels. The ratio of infarct to total area of a given slice, the percentage of infarct area per slice (PIS), was calculated. MO as a percentage of total infarct area was also calculated. Results: The average density values on DE-MDCT (5 minutes after contrast injection) were remote normal myocardium of 93 ± 19 Hounsfield units (HU), infarct myocardium of 159 ± 40 HU, blood of 140 ± 26 HU, and MO of 85 ± 30 HU. PISMDCT showed substantial agreement with PISTTC (y = 1.003x + 4.12; R = 0.90, P < 0.05). A relation was also shown between MO determined by MDCT compared with H&E staining (y = 0.74x + 3.4). Conclusions: We show the feasibility of using a semiautomated SI threshold technique for quantification of subacute myocardial infarct. We also show the persistent MO in subacute myocardial infarct on DE-MDCT images.

Original languageEnglish
Pages (from-to)26-32
Number of pages7
JournalJournal of Cardiovascular Computed Tomography
Issue number1
Publication statusPublished - Jan 1 2008



  • Delayed enhancement
  • Magnetic resonance imaging
  • Microvascular obstruction
  • Multidetector CT
  • Myocardial infarct
  • No-reflow zone

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ruzsics, B., Surányi, P., Kiss, P., Brott, B. C., Singh, S. S., Litovsky, S., Aban, I., Lloyd, S. G., Simor, T., Elgavish, G. A., & Gupta, H. (2008). Automated multidetector computed tomography evaluation of subacutely infarcted myocardium. Journal of Cardiovascular Computed Tomography, 2(1), 26-32.