CAJ | 학술논문

目的探讨多层螺旋CT(MSCT)双期扫描对急性心肌梗死动物模型的梗死心肌灌注和范围的评估价值.方法 5头家猪以球囊封闭左前降支远端90 min后撤除球囊完成再灌注.30 min后行MSCT检查,静脉团注100 mL对比剂后1 min(早期扫描相)与5 min(延迟扫描相)接受2次MSCT扫描.取出心脏后切成8 mm厚短轴面切片并行氯化三苯基四氮唑(TTC)染色.MSCT延迟扫描相高增强和周边低增强区域之和及TTC不染色区域定义为梗死区域;梗死容积以各层面容积总和的百分比表示.结果 MSCT上梗死心肌在早期扫描相表现为早期灌注缺损,在延迟扫描相表现为晚期增强和残余灌注缺损.早期扫描相早期灌注缺损区CT值低于正常区域[(213±55)HU vs(304±30)HU](P<0.05),延迟扫描相晚期增强区CT值高于正常区域[(360±75)HU vs(90±37)HU](P<0.01),而残余灌注缺损区低于正常区域[(152±23)HU vs(190±37)HU](P<0.05).梗死容积百分比,MSCT测得为(8.9±1.0)%,TTC病理染色为(9.2±1.4)%,两者具有一致性.结论 MSCT双期扫描在急性心肌梗死早期有不同于正常区域的特征性增强表现,对于评价心肌梗死容积与病理学方法可比性高.
목적 탐토다층라선CT(MSCT)쌍기소묘대급성심기경사동물모형적경사심기관주화범위적평고개치.방법 5두가저이구낭봉폐좌전강지원단90 min후철제구낭완성재관주.30 min후행MSCT검사,정맥단주100 mL대비제후1 min(조기소묘상)여5 min(연지소묘상)접수2차MSCT소묘.취출심장후절성8 mm후단축면절편병행록화삼분기사담서(TTC)염색.MSCT연지소묘상고증강화주변저증강구역지화급TTC불염색구역정의위경사구역;경사용적이각층면용적총화적백분비표시.결과 MSCT상경사심기재조기소묘상표현위조기관주결손,재연지소묘상표현위만기증강화잔여관주결손.조기소묘상조기관주결손구CT치저우정상구역[(213±55)HU vs(304±30)HU](P<0.05),연지소묘상만기증강구CT치고우정상구역[(360±75)HU vs(90±37)HU](P<0.01),이잔여관주결손구저우정상구역[(152±23)HU vs(190±37)HU](P<0.05).경사용적백분비,MSCT측득위(8.9±1.0)%,TTC병리염색위(9.2±1.4)%,량자구유일치성.결론 MSCT쌍기소묘재급성심기경사조기유불동우정상구역적특정성증강표현,대우평개심기경사용적여병이학방법가비성고.
Objective To explore the value of dual-phase contrast-enhancement multislice computed tomography (MSCT) in the assessment of acute myocardial infarction volume and perfusion in porcine models. Methods The distal left anterior descending coronary arteries of 5 pigs were balloon-occluded for 90 min and followed by reperfusion. MSCT was performed 1 min (early phase) and 5 min (delayed phase) after administration bolus of 100 mL of iodinated contrast material 30 min after reperfusion. On the same day, hearts were excised, sectioned in 8 mm short-axis slices, and stained with TTC. Infarction volume was defined as the sum of the hyper-enhanced area and surrounding hypo-enhanced area in all slices on delay enhanced phase of MSCT and the TTC-negative area on TTC staining slices. Infarction volume was expressed as percentage of total slice volume. Results Acute infarction detected by MSCT was characterized by early myocardial perfasion defects in the early phase of the contrast bolus (early defects) with surrounding residual defects and late enhancement observed in the late phase. Mean CT attenuation value of early defects was significantly different from CT attenuation value of remote myocardium [(213±55)HU vs (304±30)HU](P < 0.05), CT attenuation values of residual defects and late enhancement were also significantly different from those of remote myocardium [(360±75) HU vs (90±37) HU and (152±23) HU vs (190±37) HU, repectively](P < 0.01, P < 0.05). The mean infarction volume was (8.9± 1.0)% on MSCT and (9.2±1.4)% on TTC pathology images. The infarction volume assessed by MSCT compared well with TTC staining slices. Conclusion Acute reperfused myocardial infarction zone has specific enhancement pattens different to remote normal zone on dual phase MDCT, which is in good agreement with in vivo Trc pathology in the assessment of acute reperfused myocardial infarction shortly offer reperfusion.