犬急性心肌梗死模型的多层螺旋CT心肌灌注和冠状动脉造影

MSCT myocardial perfusion and coronary angiography in dog acute myocardial infarction model

目的 :研究急性心肌缺血和梗死的多层螺旋CT(MSCT)心肌灌注特点 ,探索MSCT冠状动脉造影对冠状动脉阻断的显示情况。方法 :犬左冠状动脉前降支结扎前、后不同时期分别进行MSCT心肌灌注扫描 ,分析其特点 ,并与病理检查相对照 ;同时做MSCT冠状动脉造影观察冠状动脉阻断的情况。结果 :犬心肌正常灌注量为 ( 69.3±1 3 .9)ml·1 0 0g- 1·min- 1、达峰值时间 ( 1 2 .8± 2 .1 )sec。左冠状动脉前降支结扎 3 0min后MSCT心肌灌注表现为灌注量减低 ,时间密度曲线低平 ,延迟 1 0min扫描局部心肌密度无显著改变。结扎 4h后 ,局部心肌呈明显延迟增强。MSCT冠状动脉造影显示冠状动脉前降支中断。结论 :MSCT心肌灌注结合冠状动脉造影可以判断心肌缺血和梗死 。

Objective: To study myocardial perfusion in acute myocardial infarction with MSCT, and to explore the value of MSCT coronary angiography in demonstrating coronary artery blockage. Methods: The left anterior descending artery (LAD) was ligated in healthy dogs and MSCT perfusion scans were done in several stages. The perfusion peculiarity was analyzed and compared with pathological findings. MSCT coronary angiography was done before and after LAD ligated. Results: The normal mean myocardial perfusion was (69.3±13.9) ml·100 g-1·min-1; the mean time to peak (TTP) was (12.8±2.1) sec. After LAD was ligated, the myocardial perfusion became significantly lower than normal, and Time Density Carve became flat. In delayed 10 seconds scans, there was no significant difference between normal myocardium and the myocardium after LAD ligated for 30 seconds, but significantly high enhancement was found after LAD tied for 4 h. MSCT coronary angiography showed the blockage of LAD. Conclusion: MSCT myocardial perfusion combined with coronary angiography can estimate myocardial ischemia and infarction and show the blockage of the coronary artery.