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目的:分析64排多层螺旋CT双期扫描评估急性无再灌注梗死心肌大小的精确性。方法:家猪5只,麻醉下开胸结扎前降支远端1/3处,建立急性心肌梗死模型。行64排心电门控CT双期扫描,取R-R间期的60%进行心肌重建,计算梗死心肌的容积百分比。处死动物,取心脏切片,行TTC病理染色,将得到的梗死心肌容积与CT的结果进行一致性分析。结果:5头猪成功建模,CT延迟扫描得到的梗死心肌容积百分比较首次扫描明显降低(9.78%±2.88%比11.87%±3.54%,P=0.003),下降了17.61%。TTC染色得到的梗死心肌容积百分比为9.87%±2.44%,Bland-Altmanplots方法检验与CT延迟扫描的结果有很好的相关性(平均偏差0.0112～0.0129)。结论:多层螺旋CT延迟扫描可以精确评价急性无再灌注梗死心肌的大小。
OBJECTIVE: To evaluate the accuracy of dual-phase 64-slice MSCT in assessing myocardial size in acute non-reperfusion infarction. Methods: Five domestic pigs were enrolled in this study. Acute myocardial infarction model was established by thoracotomy in the distal 1/3 of thoracotomy before anesthesia. Row 64 row ECG gated CT double-phase scan, 60% R-R interval myocardial reconstruction, calculate the percentage of myocardial infarction volume. Animals were sacrificed, heart sections were taken and TTC pathological staining was performed. The consistency between the infarcted myocardium volume and CT results was analyzed. Results: The percentage of infarcted myocardium in CT scan was significantly lower than that in the first scan (9.78% ± 2.88% vs 11.87% ± 3.54%, P = 0.003), a decrease of 17.61%. The percentage of myocardial infarction volume obtained by TTC staining was 9.87% ± 2.44%. The Bland-Altmanplots test showed a good correlation with CT delayed scan (mean deviation 0.0112 ~ 0.0129). Conclusion: Multi-slice spiral CT delayed scan can accurately evaluate the size of acute myocardial infarction without reperfusion.