急性心肌梗死的多层螺旋CT双期扫描影像学特征
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上海市卫生局科技发展基金(054027).


Dual-phase scanning characteristics of multislice spiral CT for acute myocardial infarction
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Supported by Fund of Science Committee of Health Department of Shanghai Municipal Government(054027).

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    摘要:

    目的:分析急性心肌梗死的多层螺旋CT影像学特征。方法:6只家猪开胸结扎前降支远端1/3,建立急性无再灌注心肌梗死模型,行双期螺旋CT扫描,对得到的CT影像学图像特点进行分析。结果:6只动物全部成功建模,早期CT扫描特征为造影剂灌注缺损,延迟扫描时灌注缺损面积百分比明显减少\[(13.52±5.22)% vs (9.07±3.47)%,P=0.004\],平均下降32.14%;残余灌注缺损区域周围CT值明显高于非梗死区域\[(156±21) vs (132±25) HU,P=0.004);在不同扫描时相,不同区域组织的CT值密度发生变化,心腔由(586±111) HU下降到(294±53) HU(P=0.001),非梗死区域心肌由(247±54) HU降到(132±25) HU(P=0.001),灌注缺损区域CT值无明显变化\[(29±23) vs (42±14) HU,P=0.289\]。结论:急性心肌梗死的双期螺旋CT影像学特征为早期灌注缺损,延迟灌注改善和残余灌注缺损;早期扫描高估梗死区域的面积。

    Abstract:

    Objective:To analyze the characteristics of multislice spiral computed tomography (CT) for acute myocardial infarction.Methods: The anterior descending coronary arteries of 6 pigs were ligated at the 1/3 distal end to establish acute myocardial infarction model without reperfusion.Dual multislice spiral CT scanning was performed in all animals and the CT characteristics were analyzed.Results: Acute myocardial infarction model was successfully established in all 6 animals.Myocardial perfusion deficits were detected during early phase scanning; the area of deficits were significantly decreased during late phase scanning (13.52%±5.22% vs 9.07%±3.47%,P=0.004),with a mean decrease of 32.14%.CT value of different myocardial varied at different scanning times: the values of LV cavity decreased from (586±111) HU to (294±53) HU (P=0.001),that of the normal myocardial area decreased from (247±54) HU to (132±25) HU (P=0.001); the values of the perfusion deficit regions were not significantly changed (\[42±14\] HU vs \[29±23\] HU,P=0.289).During late phase scanning,CT value around residual perfusion deficit was higher than that of normal myocardium (\[156±21\] HU vs \[132±25\] HU,P=0.004).Conclusion: The dual-phase MSCT characteristics of AMI include early perfusion deficits,late enhancement and residual perfusion deficits.Early phase scanning may overestimate the infarction area.

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  • 收稿日期:2007-12-19
  • 最后修改日期:2008-04-14
  • 录用日期:2008-04-22
  • 在线发布日期: 2008-07-16
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