Kerl J Matthias, Deseive Simon, Tandi Christa, Kaiser Christina, Kettner Mattias, Korkusuz Huedayi, Lehmann Ralf, Herzog Christopher, Schoepf U Joseph, Vogl Thomas J, Bauer Ralf W
Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
Acta Radiol. 2011 Oct 1;52(8):834-9. doi: 10.1258/ar.2011.100315. Epub 2011 Aug 26.
Detection of myocardial infarction has been the focus of considerable research over the past few decades. Recently developed dual source computed tomography (DSCT) scanners with dual energy mode have been used to detect myocardial infarction, but the studies on this topic are few.
To evaluate the feasibility and performance of dual energy CT (DECT) during arterial phase in coronary CT angiography for the detection of chronic infarction compared with late enhancement MRI (LE-MRI) and histopathology in a porcine model of reperfused myocardial infarction.
Myocardial infarctions were induced by 30 min occlusion of the proximal left anterior descending coronary artery in eight minipigs. DECT, post-contrast LE-MRI and histopathology were performed 60 days after infarct induction. The CT scan was performed in dual energy mode using a dedicated protocol. Myocardial iodine distribution was superimposed as color maps on grey scale multiplanar reformats of the heart. Two radiologists in consensus interpreted all imaging studies for presence of gadolinium uptake at LE-MRI reduced iodine content at DECT and hypoenhanced areas in the initial 100 kV coronary CT angiography images that were acquired during the DECT-acquisition. Results were compared with histopathology.
Based on evaluable segments, DECT showed a sensitivity and specificity of 0.72 and 0.88; LE-MRI showed a sensitivity and specificity of 0.78 and 0.92; and the 100 kV data-set of the DECT scan showed a sensitivity and specificity of 0.60 and 0.93, respectively, for the detection of histological proved ischemia.
DECT during arterial phase coronary CT angiography, which is ordinarily used for coronary artery evaluation, is feasible for the detection of a chronic reperfused myocardial infarction.
在过去几十年中，心肌梗死的检测一直是大量研究的重点。最近开发的具有双能量模式的双源计算机断层扫描（DSCT）扫描仪已被用于检测心肌梗死，但关于这一主题的研究较少。
在再灌注心肌梗死猪模型中，与延迟强化磁共振成像（LE-MRI）和组织病理学相比，评估双能量CT（DECT）在冠状动脉CT血管造影动脉期检测慢性梗死的可行性和性能。
在8只小型猪中，通过闭塞左前降支冠状动脉近端30分钟诱导心肌梗死。在梗死诱导后60天进行DECT、对比剂增强后的LE-MRI和组织病理学检查。使用专用方案以双能量模式进行CT扫描。心肌碘分布以彩色图叠加在心脏的灰度多平面重组图像上。两名放射科医生一致解读所有成像研究，以确定LE-MRI上钆摄取的存在、DECT上碘含量的降低以及在DECT采集期间获得的初始100 kV冠状动脉CT血管造影图像中的低增强区域。将结果与组织病理学进行比较。
基于可评估节段，DECT检测组织学证实的缺血的敏感性和特异性分别为0.72和0.88；LE-MRI的敏感性和特异性分别为0.78和0.92；DECT扫描的100 kV数据集的敏感性和特异性分别为0.60和0.93。
通常用于冠状动脉评估的动脉期冠状动脉CT血管造影中的DECT对于检测慢性再灌注心肌梗死是可行的。
