To compare myocardial enhancement of patients with cardiac amyloidosis (CA) with a group of control patients using first-pass and delayed contrast-enhanced MDCT acquisitions.

Patients Thirteen consecutive patients with CA and 11 control patients were included in this prospective study. Regarding the type of amyloidosis, 6 patients had a Transthyretin Familial Amyloidosis (FAP ATTR), 5 patients had AL amyloidosis and 2 patients had a senile systemic amyloidosis. All patients with CA had a thickening of cardiac wall (> 12 mm for left ventricle) on cardiac MRI associated with a diffuse myocardial enhancement on late gadolinium enhancement (LGE). Sixty one percent of patients (8/13) had also a positive endomyocardial biopsy...

The patients with CA exhibited significant higher wall thickness than control patients (Table 1). On first pass images, patients with CA exhibited a significantly lower SNR myoc than control subjects (Table 2). Myocardial attenuation trended to be lower in patients with CA than in control patients but the difference did not reach statistical significance (P=0.1). Blood pool attenuation, SNR blood and CNR blood-myoc were in the same range between groups. On delayed images (Table 3), myocardial attenuation and SNR myoc were significantly higher in patients...

Patients with CA exhibited a lower myocardial signal-to-noise ratio on first pass MDCT images and a higher myocardial attenuation on delayed MDCT images associated with a reduction of contrast between blood pool and myocardial attenuation in comparison to control patients. Opposite variations of myocardial enhancement on first pass and delayed acquisitions were also noticed between patients with CA and control patients. Altogether these data suggest that MDCT could be of interest in the detection of CA, especially in patients with contraindication to MRI.

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