综合影像学评价中华小型猪慢性心肌缺血  

Integrated imaging evaluation of chronic myocardial ischemia in Chinese mini-swine model

作　　者：唐翔[1] 吕滨[1] 赵世华[1] 唐跃[1] 吕凤英[1] 方纬[1] 陆敏杰[1] 鲁锦国[1] 陈雄彪[1] 蒋世良[1] 

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院放射科,北京100037

出　　处：《中国医学影像技术》2010年第3期421-424,共4页Chinese Journal of Medical Imaging Technology

基　　金：教育部新世纪优秀人才支持计划:"心脏微循环综合影像学研究"(CET-04-0189)

摘　　要：目的评价多排探测器螺旋CT(MDCT)、磁共振成像(MRI)、单光子发射型体层摄影术(SPECT)对中华小型猪慢性心肌缺血模型的显示效果。方法中华小型猪6只,接受MDCT扫描1次后,在前降支近段放置Ameroid环,当日行MDCT、MRI扫描。术后第2、27天再次行SPECT,28天完成冠状动脉造影(CAG)、MDCT、MRI,最后处死动物行病理检查。结果2只实验猪饲养中死亡,4只完成实验。病理显示3只实验猪有心内膜下梗死,1只无梗死。CAG显示3只实验猪狭窄>50%。MDCT的动脉期减低区域、MRI的首过减低区域以及SPECT的减低区域均与TTC染色显示的梗死区域一致。MDCT测得术后28天的ESV高于术前与术后当日(P<0.05),其余指标差异均无统计学意义。MRI测得EDV术后28天高于术后当日(P<0.001),其余各指标差异均无统计学意义。MDCT测得的SV、EDV均值均高于MRI(P均<0.05);二者测得的ESV与EF差异无统计学意义(P均>0.05)。术前、术后当日、术后28天左心室前壁动脉期CT值差异有统计学意义(F=10.274,P=0.011)。结论MDCT动脉期、MRI首过灌注、SPECT显示的左心室前壁灌注减低与TTC染色梗死心肌相对应。心肌缺血后CT值减低。Objective To assess multi-detector CT（MDCT）,MR and single photon emission computed tomography（SPECT） in detection of chronic myocardial ischemia in Chinese mini-swine models.Methods Six male pigs received MDCT scan firstly.Then Ameroid narrow ring was placed in the left descending branch and MDCT,MR were performed at the same day.On the 2nd,27th day,SPECT was given.Coronary angiography（CAG） was given on the 28th day,and then MDCT and MRI.The animals were killed after allexaminations.The pathological examination was given at last.Results Two pigs died during the rearing and another 4 had results.Pathology showed 3 had subendocardium infarction and 1 had no infarction.CAG showed infarction in 3 pigs with stenosis more than 50%.Areas of reduced perfusion in arterial phase MSCT,first-pass MRI and SPECT were consistent to findings of TTC staining.MDCT detected that ESV on the 28th day was higher than that of preoperative and postoperative day（P 0.05）,the other indexes had no difference.MRI displayed that EDV on the 28th day was higher than that of postoperative day（P 0.001）,the other indexes had no differences.SV and EDV measured with MDCT were higher than those with MRI（all P 0.05）.ESV and EF measured with MDCT and MRI had no statistical difference（all P 0.05）.CT value of left ventricular anterior wall on preoperative,postoperative day and the 28th day were statistically different（F= 10.274,P= 0.011）.Conclusion Arterial phase of MDCT,first-pass perfusion of MRI and SPECT all show reducing perfusion in left ventricular anterior wall corresponded to myocardial infarction with TTC staining.CT value of myocardial ischemia decreases after myocardial ischemia.

关 键 词：体层摄影术 螺旋计算机 磁共振成像 体层摄影术 发射型计算机 单光子 猪 雏型 心肌缺血 

分 类 号：R814[医药卫生—影像医学与核医学] R-332[医药卫生—放射医学]