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Table 2 Correlation between the myocardial segments showing delayed enhancement on cardiac CT and at least one other imaging modality i.e. TTE, SPECT, or cardiac MRI

From: Clinical experiences of delayed contrast enhancement with cardiac computed tomography: case series

 

Clinical indication

Contraindication to a Cardiac MRI at the time of Cardiac CT

Myocardial segments with Delayed enhancement

Comparative imaging modality

Myocardial segments on comparative modality

1

CAD -- Chest pain and inconclusive cardiac MRI. (MRI was not able to predict the cause of DE)

Anxiety causing incomplete and inconclusive Cardiac exam

Inferior wall (Transmural)

SPECT MRI

SPECT - Fixed perfusion defect in the inferior wall MRI – Delayed enhancement in Inferior wall. CTA – Obstructive disease in the dominant RCA

2

CM -- Progression of Sarcoidosis (new pacemaker precluded followup MRI)

Permanent Pacemaker

Lateral wall Apical LV wall (Patchy foci)

MRI

Lateral Apical left ventricular wall (Patchy foci)

3

CAD -- Assessment of ischemic scar

Permanent Pacemaker

Basal wall Mid lateral wall

TTE

Basal, lateral wall (severe hypokinesis) Apical wall (Hyper-reflective/ Increased echogenicity)

4

CM -- Hypertrophic cardiomyopathy and scar assessment

AICD

Basal, Mid inferior, Inferolateral, Anterolateral LV wall

TTE

Asymmetric septal hypertrophy.

5

CAD -- Scar mapping for ventricular tachycardia ablation

AICD

Basal, Mid inferolateral wall

TTE

Basal Mid inferolateral wall (Hyper-reflective/ increased echogenicity)

6

CM -- Idiopathic cardiomyopathy and Worsening ventricular arrhythmias.

AICD

Mid to apical anterior, Anteroseptal, Anterolateral LV wall

TTE

Apical (Akinesis) Anteroseptal (Akineis) Anterolateral wall (Hypokinesis) Septum and apex (Hyper-reflectivity/Increased echogenicity)

7

CM -- HCM, recurrent AICD shocks

AICD

Mid myocardium in anteroseptal Basal wall

TTE

Marked asymmetric LV hypertrophy.

8

CM -- Progression of Sarcoidosis

Permanent

Subepicardial portion of antero-septal mid ventricular wall Mid myocardial basal, Anteroseptal wall and Sub endocardial mid inferolateral wall.

TTE

Mid myocardial wall (Hypokinesis) Inferoposterior (Hyper-reflective/increased echogenicity)

  

Pacemaker

   

9

CAD -- Ventricular tachycardia storm; scar assessment

AICD

Inferior wall and Basal to apical LV, Anterior wall at basal, mid ventricular level.

TTE

Inferior, septal, apical (Akinesis) Inferior and posterior wall. (Hyper-reflective/increased echogenicity)

  1. AICD = Automated Implantable Cardioverter Defibrillator, CAD = Coronary artery disease, CM = Cardiomyopathy, C-MRI = cardiac MRI, DE = Delayed enhancement, HCM = Hypertrophic cardiomyopathy, LV = Left ventricle, PM = Pace maker, TTE = Transthoracic echocardiogram, VT = Ventricular Tachycardia.