CAJ | 학술논문

目的：探讨多层螺旋CT（ MDCT）用于评价小型猪急性心肌梗死模型梗死早期冠状动脉血流及梗死面积的价值。方法选取五指山小型猪18只，随机分成假手术组6只和模型组12只。模型组采用胸腔镜下结扎左冠状动脉左前降支制作心肌梗死模型。术前30 min和冠状动脉结扎后行冠状动脉造影，术后4 h进行MDCT扫描，96 h行超声心动图检测；最后处死动物，取心脏进行病理学染色，观察心肌缺血和梗死情况。结果假手术组各项检查均未发现异常，病理染色未发现缺血及梗死区。模型组冠状动脉造影显示术前冠状动脉通畅，血流正常，结扎冠状动脉后左前降支第一对角支远端血流完全中断；MDCT冠状动脉扫描显示左前降支血流中断，梗死区域主要分布于心尖及左心室前壁及少量的室间隔，与超声心动图及病理学染色结果一致。结论 MDCT可用于评估急性心肌梗死早期冠状动脉血流及梗死面积。
목적：탐토다층라선CT（ MDCT）용우평개소형저급성심기경사모형경사조기관상동맥혈류급경사면적적개치。방법선취오지산소형저18지，수궤분성가수술조6지화모형조12지。모형조채용흉강경하결찰좌관상동맥좌전강지제작심기경사모형。술전30 min화관상동맥결찰후행관상동맥조영，술후4 h진행MDCT소묘，96 h행초성심동도검측；최후처사동물，취심장진행병이학염색，관찰심기결혈화경사정황。결과가수술조각항검사균미발현이상，병리염색미발현결혈급경사구。모형조관상동맥조영현시술전관상동맥통창，혈류정상，결찰관상동맥후좌전강지제일대각지원단혈류완전중단；MDCT관상동맥소묘현시좌전강지혈류중단，경사구역주요분포우심첨급좌심실전벽급소량적실간격，여초성심동도급병이학염색결과일치。결론 MDCT가용우평고급성심기경사조기관상동맥혈류급경사면적。
Objective To determine the value of multidetector computed tomography ( MDCT) in evaluating the coro-nary artery blood flow and infarction size in the early phase of mini swine models with acute myocardial infarction.Methods Eighteen swine were randomly divided into the sham operation group ( n=6 ) and the model group ( n=12 ) .In the model group, mini swine were used to establish myocardial ischemia models by ligating LAD via thoracoscopy after coronary angiography.The 12-Lead ECG monitor was used to record the signals of swine 30 min before the experiment and after liga-tion of coronary artery.After 4 and 96 hours surgery, the ischemia models were detected by MDCT and echocardiography, respectively.At the end of the experiment, swine were sacrificed for pathological staining as well as myocardial ischemia and infarction.Results In pathological staining, no ischemia and infarction tissue and other abnormalities were found in the sham operation group.The coronary angiography results showed that the blood flow was normal but the first diagonal branch was completely interrupted after ligation of coronary artery in the model group, and MDCT coronary artery scanning showed no blood flow in left anterior distal coronary artery.Besides, the infarction size of MDCT scanning was consistent to echocardiography and Evans, TTC staining, which mainly distributed apex and left anterior ventricle and part of interven-tricular septum.Conclusion MDCT can be used to evaluate the early coronary blood flow and infarction size of acute myo-cardial infarction.