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目的:分析急性心肌梗死的多层螺旋CT影像学特征。方法:6只家猪开胸结扎前降支远端1/3,建立急性无再灌注心肌梗死模型,行双期螺旋CT扫描,对得到的CT影像学图像特点进行分析。结果:6只动物全部成功建模,早期CT扫描特征为造影剂灌注缺损,延迟扫描时灌注缺损面积百分比明显减少[(13.52±5.22)%vs(9.07±3.47)%,P=0.004],平均下降32.14%;残余灌注缺损区域周围CT值明显高于非梗死区域[(156±21)vs(132±25)HU,P=0.004);在不同扫描时相,不同区域组织的CT值密度发生变化,心腔由(586±111)HU下降到(294±53)HU(P=0.001),非梗死区域心肌由(247±54)HU降到(132±25)HU(P=0.001),灌注缺损区域CT值无明显变化[(29±23)vs(42±14)HU,P=0.289]。结论:急性心肌梗死的双期螺旋CT影像学特征为早期灌注缺损,延迟灌注改善和残余灌注缺损;早期扫描高估梗死区域的面积。
Objective: To analyze the multi-slice spiral CT features of acute myocardial infarction. Methods: Six domestic pigs were enrolled in this study. The left anterior descending coronary artery was ligated one third before the thoracotomy. The model of acute myocardial infarction without reperfusion was established. The images of the CT images were analyzed by double - phase spiral CT scan. Results: All 6 animals were successfully modeled. The early CT scan was characterized by contrast medium perfusion defect. The percentage of perfusion defect area in delayed scan was significantly decreased [(13.52 ± 5.22)% vs (9.07 ± 3.47)%, P = 0.004] Decreased by 32.14%. The CT value of residual perfusion defect area was significantly higher than that of non-infarcted area [(156 ± 21) vs (132 ± 25) HU, P = 0.004) The heart volume decreased from (586 ± 111) HU to (294 ± 53) HU (P = 0.001) and non-infarcted area decreased from (247 ± 54) HU to (132 ± 25) HU There was no significant change in CT value of perfusion defect area [(29 ± 23) vs (42 ± 14) HU, P = 0.289]. Conclusion: The dual-phase spiral CT features of acute myocardial infarction are early perfusion defect, delayed perfusion improvement and residual perfusion defect. Early scan overestimates infarct size.