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急性心肌梗死的多层螺旋CT双期扫描影像学特征
曲新凯1,方唯一1*,关韶峰1,沈艳2,叶剑定2,焦静2,李若谷1,艾力·麦合木提3
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(1.上海交通大学附属上海胸科医院心内科,上海 200030;2.上海交通大学附属上海胸科医院放射科,上海 200030;3.新疆阿克苏地区第一人民医院心内科,新疆 843000)
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。
关键词:  心肌梗死  多层螺旋计算机体层摄影术
DOI:10.3724/SP.J.1008.2008.00792
投稿时间:2007-12-19修订日期:2008-04-14
基金项目: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
QU Xin-kai1,FANG Wei-yi1*,GUAN Shao-feng1,SHEN Yan2,YE Jian-ding2,JIAO Jing2,LI Ruo-gu1,AILI Mai-he-mu-ti3
(1.Department of Cardiology,Shanghai Chest Hospital,Shanghai Jiaotong University,Shanghai 200030,China;2.Department of Radiology,Shanghai Chest Hospital,Shanghai Jiaotong University,Shanghai 200030;3.Department of Cardiology,First People’s Hospital of Akesu,Akesu 843000)
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.
Key words:  myocardial infarction  multislice spiral computed tomography