From the Department of Diagnostic and Interventional Radiology and Neuroradiology (F.N., K.N., M.F., T.S.), Clinic for Nuclear Medicine (T.P., A.B.), Clinic for Cardiology (E.T., A.A.M., R.E.), and Institute for Pathophysiology (G.H.), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany; and Department of Diagnostic and Interventional Radiology, University Hospital Dusseldorf, University of Dusseldorf, Dusseldorf, Germany (P.H.).
Radiology. 2015 Aug;276(2):400-7. doi: 10.1148/radiol.2015140564. Epub 2015 Apr 3.
To compare the size of the area with reduced myocardial fluorodeoxygluose (FDG) uptake with the endocardial surface area (ESA) method as a marker for the area at risk in patients with reperfused acute myocardial infarction.
The study was approved by the local institutional review board. All patients gave written informed consent prior to their examination. Twenty-five patients (mean age ± standard deviation, 54 years ± 14) underwent prospective cardiac positron emission tomography/magnetic resonance imaging after acute coronary occlusion and interventional reperfusion. On late gadolinium contrast enhancement images, the size of infarction and the area at risk, as determined with ESA, were assessed and compared with the area of reduced FDG uptake. Statistical analysis comprised paired t tests and Mann-Whitney U tests, as well as Pearson r and Spearman ρ for correlations.
In patients with infarcted myocardium and reduced FDG uptake (n = 18), a good correlation between the area of reduced FDG uptake and the area at risk according to ESA was observed (r = .70, P = .001). The area of reduced FDG uptake (31% ± 11 of left ventricular myocardial mass) was larger than the size of the infarct (10% ± 10, P < .0001) and the area at risk according to ESA (17% ± 13, P < .0001). In six patients, no late contrast enhancement was seen, whereas all patients had an area of reduced FDG uptake (29% ± 8) in the perfusion territory of the culprit artery.
In patients with reperfused acute myocardial infarction, the area of reduced FDG uptake correlates with the area at risk as determined with the ESA method and is localized in the perfusion territory of the culprit artery in the absence of necrosis, although the area of reduced FDG uptake largely overestimates the size of the infarct and the ESA-based area at risk.
比较心肌氟脱氧葡萄糖（FDG）摄取减少区域的大小与心内膜表面积（ESA）法作为再灌注性急性心肌梗死患者危险区的标记物，以评估两者之间的相关性。
本研究获得了当地机构审查委员会的批准。所有患者在检查前均签署了书面知情同意书。25 例患者（平均年龄±标准差，54 岁±14 岁）在急性冠状动脉闭塞和介入再灌注后进行前瞻性心脏正电子发射断层扫描/磁共振成像检查。在晚期钆对比增强图像上，评估并比较 ESA 确定的梗死面积和危险区面积与 FDG 摄取减少区域的相关性。统计学分析包括配对 t 检验、Mann-Whitney U 检验以及 Pearson r 和 Spearman ρ 相关分析。
在有心肌梗死和 FDG 摄取减少的患者中（n = 18），根据 ESA 计算的 FDG 摄取减少区域与危险区之间存在良好的相关性（r =.70，P =.001）。与 ESA 确定的梗死面积（10%±10）和危险区（17%±13）相比，FDG 摄取减少区域（左心室心肌质量的 31%±11）更大（P <.0001）。在 6 例患者中，未见晚期对比增强，而所有患者的罪犯动脉灌注区均存在 FDG 摄取减少区域（29%±8）。
在再灌注性急性心肌梗死患者中，FDG 摄取减少区域与 ESA 法确定的危险区相关，并且在没有坏死的情况下定位于罪犯动脉的灌注区，尽管 FDG 摄取减少区域在很大程度上高估了梗死面积和 ESA 确定的危险区面积。
