第二代双源CT双能量心肌灌注评价猪心肌梗死的实验研究

The evaluation of myocardial infarction with dual-energy myocardial perfusion by using the second generation dual-source CT: an experimental study in pig phantom

目的评价第二代双源CT双能量心肌灌注"一站式"扫描得到的猪急性心肌梗死模型心肌灌注图像及冠状动脉图像的可行性和准确性。方法 5只猪行介入明胶海绵栓塞法建立猪急性心肌梗死模型。分别于造模前20 min及造模后24～48 h行"一站式"扫描和冠状动脉造影。检查结束后立即取出心脏多点取活检行苏木素-伊红(HE)染色,然后将心脏切成薄片行氯化三苯基四氮唑(TTC)染色。以冠状动脉造影及病理染色为金标准分别评价第二代双源CT双能量心肌灌注"一站式"扫描重建得到猪急性心肌梗死模型的冠状动脉图像及心肌灌注图像的敏感性、特异性。以Kappa检验分析结果的一致性。结果与病理金标准对比,"一站式"扫描得到心肌灌注碘图像的敏感性、特异性分别为93%、91%,Kappa值为0.82;与冠状动脉造影金标准对比,"一站式"扫描得到冠状动脉图像的敏感性、特异性分别为93%、81%,Kappa值为0.71。结论第二代双源CT双能量心肌灌注"一站式"扫描可以准确得到猪急性心肌梗死模型的冠状动脉图像及心肌灌注图像。

Objective To evaluated the feasibility and accuracy of obtaining the myocardial perfusion image and coronary artery image of pig models of acute myocardial infarction by the second generation dual-source CT dual-energy myocardial perfusion ＆quot;one-stop＆quot; scanning. Methods The pig models of acute myocardial infarction was established by using the interventional gelatin sponge embolism method on 5 pigs. The myocardial perfusion scanning and coronary angiography were respectively used 20 min before and 24-48 h after modeling. The heart were taken out immediately after the inspection for multiple punch biopsy and HE staining, then the heart was sliced for triphenyltetrazolium chloride （TTC） staining. According to the gold standard of coronary angiography and pathological staining, the sensibility and speciifcity of the coronary artery image of acute myocardial infarction of pig reconstructed by myocardial perfusion scanning and the myocardial perfusion image were respectively evaluated, and the consistency of the results was veriifed by Kappa test. Results Compared with the pathologic gold standard, the sensitivity, speciifcity, of myocardial perfusion iodine image obtained by myocardial perfusion scanning were 93%, 91%; and Kappa value was 0.68. Compared with the coronary angiography gold standard, the sensitivity and speciifcity of coronary artery image obtained by myocardial perfusion scanning were 93%, 81%, and Kappa value was 0.71. Conclusions The second generation dual-source CT dual-energy myocardial perfusion＆quot;one-stop＆quot;scanning can accurately get the coronary artery and myocardial perfusion images of the pig models of acute myocardial infarction.