From the Department of Mechanical Engineering, University College London, London, England (J.B., C.L.W., C.B., E.B.O.L., R.T., P.D.L.); European Synchrotron Radiation Facility, 71 Av des Martyrs, 38000 Grenoble, France (J.B., P.T., C.B., K.D.); UCL Institute of Cardiovascular Science, London, England (A.C.C.); Wellcome Sanger Institute, Hinxton, England (J.C.); Siemenst Healthineers, Erlangen, Germany (K.E.); Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, England (O.A.); Laboratoire d'Anatomie des Alpes Françaises, Université Grenoble Alpes, Grenoble, France (A.B.); Institute of Pathology, Hannover Medical School, Hannover, Germany (C.W.); Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research (DZL), Hannover, Germany (D.D.J.); Institute of Pathology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany (D.D.J., M.A.); Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, Universität Witten/Herdecke, Wuppertal, Germany (M.A.); Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany (M.A.); and Research Complex at Harwell, Didcot, England (P.D.L.).
Radiology. 2024 Jul;312(1):e232731. doi: 10.1148/radiol.232731.
Background Current clinical imaging modalities such as CT and MRI provide resolution adequate to diagnose cardiovascular diseases but cannot depict detailed structural features in the heart across length scales. Hierarchical phase-contrast tomography (HiP-CT) uses fourth-generation synchrotron sources with improved x-ray brilliance and high energies to provide micron-resolution imaging of intact adult organs with unprecedented detail. Purpose To evaluate the capability of HiP-CT to depict the macro- to microanatomy of structurally normal and abnormal adult human hearts ex vivo. Materials and Methods Between February 2021 and September 2023, two adult human donor hearts were obtained, fixed in formalin, and prepared using a mixture of crushed agar in a 70% ethanol solution. One heart was from a 63-year-old White male without known cardiac disease, and the other was from an 87-year-old White female with a history of multiple known cardiovascular pathologies including ischemic heart disease, hypertension, and atrial fibrillation. Nondestructive ex vivo imaging of these hearts without exogenous contrast agent was performed using HiP-CT at the European Synchrotron Radiation Facility. Results HiP-CT demonstrated the capacity for high-spatial-resolution, multiscale cardiac imaging ex vivo, revealing histologic-level detail of the myocardium, valves, coronary arteries, and cardiac conduction system across length scales. Virtual sectioning of the cardiac conduction system provided information on fatty infiltration, vascular supply, and pathways between the cardiac nodes and adjacent structures. HiP-CT achieved resolutions ranging from gross (isotropic voxels of approximately 20 µm) to microscopic (approximately 6.4-µm voxel size) to cellular (approximately 2.3-µm voxel size) in scale. The potential for quantitative assessment of features in health and disease was demonstrated. Conclusion HiP-CT provided high-spatial-resolution, three-dimensional images of structurally normal and diseased ex vivo adult human hearts. Whole-heart image volumes were obtained with isotropic voxels of approximately 20 µm, and local regions of interest were obtained with resolution down to 2.3-6.4 µm without the need for sectioning, destructive techniques, or exogenous contrast agents. Published under a CC BY 4.0 license See also the editorial by Bluemke and Pourmorteza in this issue.
背景 当前的临床成像方式，如 CT 和 MRI，具有足够的分辨率来诊断心血管疾病，但无法在长度尺度上描绘心脏的详细结构特征。基于第四代同步加速器源的分层相衬断层摄影术（HiP-CT）利用改良的 X 射线亮度和高能，提供具有前所未有的细节的完整成人器官的微米分辨率成像。
目的 评估 HiP-CT 描绘结构正常和异常成人心脏大体到微观解剖结构的能力。
材料和方法 2021 年 2 月至 2023 年 9 月，获取了 2 例成人供体心脏，福尔马林固定，并用粉碎的琼脂与 70%乙醇溶液的混合物进行处理。其中 1 例来自 63 岁的白人男性，无已知心脏病，另 1 例来自 87 岁的白人女性，有多种已知的心血管病理，包括缺血性心脏病、高血压和心房颤动。使用欧洲同步辐射设施的 HiP-CT 对这些心脏进行无外源性对比剂的非破坏性离体成像。
结果 HiP-CT 显示了离体高空间分辨率、多尺度心脏成像的能力，在长度尺度上揭示了心肌、瓣膜、冠状动脉和心脏传导系统的组织学水平细节。心脏传导系统的虚拟切片提供了关于脂肪浸润、血管供应以及心脏节点和相邻结构之间通路的信息。HiP-CT 实现了从大体（各向同性体素约 20 µm）到微观（约 6.4-µm 体素大小）再到细胞（约 2.3-µm 体素大小）的分辨率。还证明了在健康和疾病中定量评估特征的潜力。
结论 HiP-CT 提供了结构正常和病变的离体成人心脏的高空间分辨率、三维图像。整个心脏的体素分辨率约为 20 µm，局部感兴趣区域的分辨率可达 2.3-6.4 µm，无需切片、破坏性技术或外源性对比剂。在本期杂志中，Bluemke 和 Pourmorteza 还发表了一篇社论。
