急性心肌梗死的多层螺旋CT双期扫描影像学特征  

Dual-phase scanning characteristics of multislice spiral CT for acute myocardial infarction

作　　者：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 

机构地区：[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

出　　处：《第二军医大学学报》2008年第7期792-795,共4页Academic Journal of Second Military Medical University

基　　金：上海市卫生局科技发展基金(054027)~~

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。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 muhislice 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 I.V 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 seanning,CT value around residual perfusion deficit was higher than that of normal myoeardium （[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.

关 键 词：心肌梗死 多层螺旋计算机体层摄影术 

分 类 号：R542.22[医药卫生—心血管疾病]