Sixty-four-MSCT in the characterization of porcine acute and subacute myocardial infarction: Determination of transmurality in comparison to magnetic resonance imaging and histopathology
Sixty-four-MSCT in the characterization of porcine acute and subacute myocardial infarction: Determination of transmurality in comparison to magnetic resonance imaging and histopathology
复制标题
DOI：
10.1016/j.ejrad.2006.11.031
复制
发表时间：
2007-05-01
影响因子：
3.3
通讯作者：
Kopp, A. F.
中科院分区：
文献类型：
--
作者：
Brodoefel, H.;Klumpp, B.;Kopp, A. F.
目的：本研究的目的是评估 MSCT 在表征心肌梗死 (MI) 方面的准确性，从而与 MRI 和组织学比较确定早期灌注缺损 (ED)、微血管阻塞 (MO) 和晚期增强透壁深度 (LE) 的程度。 材料和方法：在临时性治疗后中位 1 天和 21 天对 7 头猪进行 MSCT (Somatom Sensation 64) 和 MRI (Magnetom Sonata) 研究对角分支的闭塞和小再灌注梗塞的产生。为了描述 ED，在早期动脉期和 35 秒后采集 CT 图像；根据 3、5、10 和 15 分钟获得的图像评估 LE 和 MO。因此，使用推注/低流量造影剂注射方案。获得氯化三苯基四唑（TTC）染色和组织学结果。增强模式的体积以心室的百分比进行评估，并通过 Bland-Altman 分析进行比较。使用加权 kappa 测试评估节段共定位和分级透壁性。结果：MRI-MO 和 MSCT-MO（偏差 = 0.55；5 分钟 MSCT 时 CI = -1.49 至 2.60）、TTC 和 MSCT-LE（偏差 = -1.28；CI = -3.76 至 1.19）或 MRI-LE 和 MSCT-LE 观察到紧密的空间一致性（偏差= -0.79；CI = -4.19 至 2.60）。 MO 具有良好的节段共定位（加权 kappa 0.93），TTC、MRI-LE 和 MSCT-LE 的透壁范围高度一致（加权 kappa = 0.84 TTC 与 MSCT；MRI 与 MSCT 0.86）。动脉和 35 s ED 显着低估了梗死面积，并且节段性或透壁一致性较差（加权 kappa = 0.33；0.44）。结论：MSCT 后期扫描不仅可靠地描绘了急性或亚急性梗塞期 MO 和 LE 的大小，而且还可以准确确定 LE 透壁性。 (c) 2006 Elsevier Ireland Ltd. 保留所有权利。
Objective: The aim of this study was to assess the accuracy of MSCT in characterizing myocardial infarction (MI) and, thereby, determine the extent of early perfusion defect (ED), microvascular obstruction (MO) and transmural depth of late enhancement (LE) in comparison to MRI and histology.Materials and methods: Seven pigs were studied with MSCT (Somatom Sensation 64) and MRI (Magnetom Sonata) a median 1 and 21 days following temporary occlusion of a diagonal branch and creation of small reperfused infarction.For depiction of ED, CT images were acquired in the early arterial phase and following 35 s; LE and MO were evaluated on images obtained at 3, 5, 10 and 15 min. Thereby, a bolus/low-flow contrast injection protocol was used. Triphenyltetrazolium-chloride (TTC) stain and histology were obtained. Volumes of enhancement patterns were assessed as percentage of the ventricle and compared by Bland-Altman analysis. Segmental co-localization and graded transmurality was evaluated with weighted-kappa-test.Results: Close spatial agreement was observed for MRI-MO and MSCT-MO (bias= 0.55; CI = -1.49 to 2.60 at 5 min MSCT), TTC and MSCT-LE (bias= -1.28; CI = -3.76 to 1.19) or MRI-LE and MSCT-LE (bias= -0.79; CI = -4.19 to 2.60). There was good segmental co-localization for MO (weighted kappa 0.93) and high agreement for transmural extent of TTC, MRI-LE and MSCT-LE (weighted kappa = 0.84 TTC versus MSCT; 0.86 MRI versus MSCT). Arterial and 35 s ED significantly underestimated infarct size and showed poor segmental or transmural agreement (weighted kappa = 0.33; 0.44).Conclusions: MSCT late-scans not only reliably depict size of MO and LE in acute or subacute infarct phases but, moreover, allow for accurate determination of LE transmurality. (c) 2006 Elsevier Ireland Ltd. All rights reserved.