Evaluation of Extracellular Volume Fraction in Carbon Monoxide Poisoning Patients Using Cardiac CT and MRI

Extracellular volume fraction (ECV) quantifies changes in the myocardial extracellular space and has traditionally been measured using cardiovascular magnetic resonance (CMR). However, CMR is time-consuming, costly, and not suitable for all patients. This study aimed to evaluate whether cardiac CT-derived ECV (CT-ECV) is comparable to CMR-derived ECV (MRI-ECV) without significant differences and to assess the clinical practicality of CT-ECV. Paired ECV measurements from cardiac CT and CMR in the same patients were compared using mean difference and intraclass correlation coefficient (ICC). The results showed a mean difference of -0.36% between MRI-ECV and CT-ECV, indicating close agreement, supported by a high ICC. Furthermore, CT-ECV exam time was shorter, costs were lower, and accessibility was better, suggesting clinical feasibility. In conclusion, CT-ECV demonstrated reliability comparable to MRI-ECV and could serve as a practical alternative for myocardial tissue characterization. Further research with larger cohorts and advanced statistical analyses is warranted to refine its clinical utility and clarify CT’s role in the early diagnosis and prognosis of cardiac diseases.