Contrast-Enhanced C-arm Computed Tomography Imaging of Myocardial Infarction in the Interventional Suite.
Contrast-Enhanced C-arm Computed Tomography Imaging of Myocardial Infarction in the Interventional Suite.
复制标题
介入治疗室中心肌梗塞的对比增强 C 形臂计算机断层扫描成像。
DOI：
10.1097/rli.0000000000000138
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发表时间：
2015
影响因子：
6.7
通讯作者：
Fahrig,Rebecca
中科院分区：
文献类型：
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作者：
Girard,ErinE;Al-Ahmad,Amin;Rosenberg,Jarrett;Luong,Richard;Moore,Teri;Lauritsch,Günter;Chan,Frandics;Lee,DavidP;Fahrig,Rebecca
目的心脏c臂计算机断层扫描（CT）使用标准的c臂透视系统在患者周围旋转，在介入过程中提供类似CT的图像，而无需将患者移动到传统的CT扫描仪。我们假设c臂CT可以使用类似于之前的CT和磁共振成像研究的对比增强技术来可视化和量化心肌梗死（MI）引起的灌注缺陷和晚期增强的大小。材料与方法对12头猪的急性和亚急性心肌梗死进行了冠状动脉球囊闭塞再灌注的研究。在梗死发生当天（n= 6）或梗死发生后4周（n= 6）获取心电图门控c臂CT图像。在注射造影剂后立即获得图像，然后在1分钟，每5分钟直到30分钟，没有额外的造影剂。将c臂CT测量的梗死体积与病理进行比较。结果急性心肌梗死的体积表现为高增强区与低增强区合并，与病理染色具有良好的相关性（一致性相关性为0.89；P< 0.0001；平均[SD]差为0.67 [2.98]cm 3）。注射造影剂后5 ~ 15分钟，亚急性心肌梗死的体积与病理染色的相关性良好（一致性相关性为0.82；P< 0.001；平均差为- 0.64 [1.94]cm 3）。结论在猪急性和亚急性心肌梗死模型中，c臂CT显示是可能的，但在临床应用前，影像学技术的改进是重要的。在导管实验室中，心肌梗死的可视化是可能的，并且可以在介入过程中提供三维图像指导。
ObjectivesCardiac C-arm computed tomography (CT) uses a standard C-arm fluoroscopy system rotating around the patient to provide CT-like images during interventional procedures without moving the patient to a conventional CT scanner. We hypothesized that C-arm CT can be used to visualize and quantify the size of perfusion defects and late enhancement resulting from a myocardial infarction (MI) using contrast-enhanced techniques similar to previous CT and magnetic resonance imaging studies.Materials and MethodsA balloon occlusion followed by reperfusion in a coronary artery was used to study acute and subacute MI in 12 swine. Electrocardiographically gated C-arm CT images were acquired the day of infarct creation (n= 6) or 4 weeks after infarct creation (n= 6). The images were acquired immediately after contrast injection, then at 1 minute, and every 5 minutes up to 30 minutes with no additional contrast. The volume of the infarct as measured on C-arm CT was compared against pathology.ResultsThe volume of acute MI, visualized as a combined region of hyperenhancement with a hypoenhanced core, correlated well with pathologic staining (concordance correlation, 0.89; P< 0.0001; mean [SD] difference, 0.67 [2.98] cm 3). The volume of subacute MI, visualized as a region of hyperenhancement, correlated well with pathologic staining at imaging times 5 to 15 minutes after contrast injection (concordance correlation, 0.82; P< 0.001; mean difference,− 0.64 [1.94] cm 3).ConclusionsC-arm CT visualization of acute and subacute MI is possible in a porcine model, but improvement in the imaging technique is important before clinical use. Visualization of MI in the catheterization laboratory may be possible and could provide 3-dimensional images for guidance during interventional procedures.