Comparison of the different imaging time points in delayed phase cardiac CT for myocardial scar assessment and extracellular volume fraction estimation in patients with old myocardial infarction

  • Ahmed Hamdy
  • Kakuya KitagawaEmail author
  • Yoshitaka Goto
  • Akimasa Yamada
  • Satoshi Nakamura
  • Masafumi Takafuji
  • Naoki Nagasawa
  • Hajime Sakuma
Original Paper


Delayed enhancement cardiac CT is a potential tool for myocardial viability assessment and is essential for extracellular volume fraction (ECV) estimation with CT. The objective of this study is to determine the optimal delay time for acquisition of delayed CT scans. Thirty-five patients with enhancement pattern typical of previous myocardial infarction on delayed CT and 17 control subjects comprised the study population. Delayed scans were acquired at 3, 5 and 7 min after contrast material injection. Image quality and estimated ECV were compared among the three time points. Delayed CT at 5 min showed the highest signal-to-noise ratio of 15.2 ± 1.0 [p < 0.0001; vs. 3 min (13.6 ± 1.0), p = 0.0015; vs. 7 min (14.9 ± 1.0)]. Contrast-to-noise ratio of infarcted and remote myocardium was highest at 7 min (6.4 ± 2.5), but was not significantly different from 5 min (6.1 ± 2.2, p = 0.08). The ECV values were constant over the three time points, although, in segments containing infarcted myocardium, trend of lower values was noted at 3 min compared to 5 and 7 min. ECV values at 5 min was 27.1% ± 2.1% in control subjects, 27.2% ± 3.0% in remote segments of patients with infarction, and 39.6% ± 5.3% in segments containing infarcted myocardium. Myocardial scars are equally best visualized with delay time of 5 and 7 min post contrast administration. No significant difference was observed in ECV of healthy myocardium or focal scars among delay time of 3, 5, and 7 min. Delay time of 5 min after contrast injection may be recommended for CT delayed enhancement imaging.


Diagnostic cardiac imaging Cardiovascular disease Myocardial infarction Myocardial viability assessment Extracellular volume fraction X-ray computed tomography 


Compliance with ethical standards

Conflict of interest

One of the authors (H.S.) received a research grant from DAIICHI SANKYO COMPANY, LIMITED, Fuji Pharma Co., Ltd., FUJIFILM RI Pharma Co., Ltd., Eisai Co., Ltd. All the other authors have nothing to disclose.

Supplementary material

10554_2018_1513_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 18 KB)


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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Mie University HospitalTsuJapan

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