静息态收缩期心肌灌注成像诊断猪慢性心肌缺血的可行性研究

摘要
图/表
参考文献(19)
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探讨静息态收缩期CT心肌灌注成像（CTP）诊断猪慢性心肌缺血的准确性及其与腺苷负荷动态CT灌注成像（ASDCTP）诊断心肌缺血能力的差异。方法：建立小型猪慢性心肌缺血模型，行13N-NH3 PET静息-腺苷负荷心肌灌注成像（MPI）获得静息态收缩期CTP及腺苷负荷动态 CTP。分别利用心肌透壁灌注比（TPR）和心肌节段血流量值（MBF）评估静息态收缩期CTP、腺苷负荷动态CTP各节段心肌缺血情况；以PET-MPI为金标准，评估静息态下收缩期CTP及腺苷负荷动态CTP诊断心肌缺血的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性，并采用ROC曲线对两种检查的诊断价值进行比较。P<0.05为差异有显著统计学意义。结果：静息态收缩期CTP及腺苷负荷动态CTP诊断心肌损伤的准确性分别为75.89%和83.92%；敏感性、特异性、NPV和PPV分别为68.75%、81.25%、73.33%、77.61%和83.33%、84.37%、80.0%、87.1%。静息态收缩期CTP及腺苷负荷动态CTP的ROC曲线下面积（AUC）分别为0.75、0.84，P=0.07（P＞0.05）。结论：静息态下收缩期心肌灌注成像诊断猪慢性心肌缺血具有可行性。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	杨奕婧1
	侯阳1
	马跃1
	张晓娟2
	王玉科3
	余美4
	隋时1

关键词 ：心肌缺血, 体层摄影术, X线计算机

Abstract：Objective: To determine the accuracy of the resting systolic myocardial perfusion imaging to assess myocardial ischemia with chronic coronary stenosis and the diagnostic differences capability of the dynamic adenosine-stress CT perfusion using a porcine animal. Methods: The chronic coronary stenosis models was build. 13N-NH3 PET adenosine stress-rest myocardial perfusion imaging(MPI) was obtained in order to have the resting systolic myocardial perfusion imaging(CTP) and the adenosine stress dynamic CT myocardial perfusion imaging(ASDCTP). The myocardial perfusion defect on the resting systolic CTP and ASDCTP were analyzed for the transmural differences in perfusion using the transmural perfusion ratio(TPR) and the myocardial blood flow(MBF) value, respectively. Taking PET-MPI as the reference standard, the sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of CTP in the diagnosis of myocardial perfusion defect segments were evaluated. Using receiver operating characteristic curve(ROC) to assess the value analysis of the resting systolic CTP and ASDCTP. The threshold of significance was P＜0.05. Results: The accuracy of the resting systolic CTP and ASDCTP to detect perfusion abnormalities using PET-MPI as the gold standard were 75.89% and 83.92%; The sensitivity, specificity, PPV and NPV were 68.75%, 81.25%, 73.33%, 77.61% and 83.33%, 84.37%, 80.0%, 87.1%, respectively. The area under the receiver operating characteristic curve(AUC) of the resting systolic and the adenosine stress dynamic CTP were 0.75 and 0.84, respectively, P=0.07(P＞0.05). Conclusion: The resting systolic myocardial perfusion imaging to assess chronic myocardial ischemia using a porcine animal is feasible.

Key words： Myocardial ischemia Tomography, X-ray computed

收稿日期: 2017-04-01

PACS:	Ｒ542.2
	Ｒ814.42

基金资助:国家自然科学基金（项目编号：81301221）；辽宁省教育厅高等学校创新团队（项目编号：LT201417）。

通讯作者: 侯阳，中国医科大学附属盛京医院放射科，110004。E-mail：houyang1973@163.com

作者简介: 杨奕婧（1990-），女，辽宁营口人，住院医师。现工作单位为辽宁电力中心医院放射科。E-mail：52396905@qq.com

引用本文:

杨奕婧1，侯阳1，马跃1，张晓娟2，王玉科3，余美4，隋时1. 静息态收缩期心肌灌注成像诊断猪慢性心肌缺血的可行性研究[J]. 中国临床医学影像杂志, 2018, 29(2): 92-96.
YANG Yi-jing1, HOU Yang1, MA Yue1, ZHANG Xiao-juan2, WANG Yu-ke3, YU Mei4, SUI Shi1. Feasibility of the resting systolic myocardial perfusion imaging to #br# assess chronic myocardial ischemia using a porcine animal. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(2): 92-96.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2018/V29/I2/92

[1]Cury RC, Kitt TM, Feaheny K, et al. A randomized, multicenter, multivendor study of myocardial perfusion imaging with regadenoson CT perfusion vs single photon emission CT[J]. J Cardiovasc Comput Tomogr, 2015, 9(2): 103-112.
[2]Bamberg F, Hinkel R, Marcus RP, et al. Feasibility of dynamic CT-based adenosine stress myocardial perfusion imaging to detect and differentiate ischemic and infarcted myocardium in an large experimental porcine animal model[J]. Int J Cardiovasc Imaging, 2014, 30(4): 803-812.
[3]Schwarz F, Hinkel R, Baloch E, et al. Myocardial CT perfusion imaging in a garge animal model: comparison of dynamic versus single-phase acquisitions[J]. JACC: Cardiovasc Imaging, 2013, 6(12): 1229-1238.
[4]Branch RK, Busey J, Mitsumori LM, et al. Diagnostic performance of resting CT myocardial perfusion in patients with possible acute coronary syndrome[J]. AJR, 2013, 200(5): 450-457.
[5]Troupis JM, Karge K, Seneviratne S, et al. Myocardial density analysis utilizing automated myocardial defect analysis software on resting 320-detector MDCT[J]. Int J Cardiovas Imaging, 2013, 29(5): 1121-1127.
[6]施冰，郭艳红，邓小莉，等. 中国实验小型猪慢性心肌缺血模型的制备[J]. 中国临床保健杂志，2006，9（2）：134-136.
[7]文利，崔建华，黄河，等. 适于影像学研究的猪慢性心肌缺血模型的制备[J]. 第三军医大学学报，2010，32（12）：1245-1248.
[8]Cerqueira MD, Weissman NJ, Dilsizian V, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart[J]. Circulation, 2002, 105(4): 524-539.
[9]George RT, Arbab-Zadeh, Miller JM, et al. Adenosine Stress 64- and 256-Row Detector Computed Tomography Angiography and Perfusion Imaging A Pilot Study Evaluating the Transmural Extent of Perfusion Abnormalities to Predict Atherosclerosis Causing Myocardial Ischemia[J]. Circ Cardiovasc Imaging, 2009, 2(3): 174-182.
[10]Bamberg F, Marcus RP, Becker A, et al. Dynamic myocardial CT perfusion imaging for evaluation of myocardial ischemia as determined by MR Imaging[J]. JACC: Cardiovasc Imaging, 2014, 7(3): 267-277.
[11]Toyota E, Fujimoto K, Ogasawara Y, et al. Dynamic changes in three-dimensional architecture and vascular volume of transmural coronary microvasculature between diastolic- and systolic-arrested rat hearts[J]. Circulation, 2002, 105(5): 621-626.
[12]Pugliese F, Mollet NR, Runza G, et al. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris[J]. Eur Radiol, 2006, 16(3): 575-582.
[13]Iwanaga S, Ewing SG, Husseini WK, et al. Changes in contractility and afterload have only slight effects on subendocardial systolic flow impediment[J]. Am J Physiol, 1995, 269(4 Pt 2): 1202-1212.
[14]Chilian WM. Microvascular pressures and resistances in the left ventricular subepicardium and subendocardium[J]. Circ Res, 1991, 69(3): 561-570.
[15]Iwasaki K, Matsumoto T. Myocardial perfusion defect in patients with coronary artery disease demonstrated by 64-multidetector computed tomography at rest[J]. Clin Cardiol, 2011, 34(7): 454-460.
[16]Busch JL, Alessio AM, Caldwell JH, et al. Myocardial hypo-enhancement on resting computed tomography angiography images accurately identifies myocardial hypoperfusion[J]. J Cardiovasc Comput Tomogr, 2011, 5(6): 412-420.
[17]Henneman MM, Schuijf JD, Dibbetsschneider P, et al. Comparison of multislice computed tomography to gated single-photon emission computed tomography for imaging of healed myocardial infarcts[J]. Am J Cardiol, 2008, 101(2): 144-148.
[18]Bauer RW, Kerl JM, Fischer N, et al. Dual-energy CT for the assessment of chronic myocardial infarction in patients with chronic coronary artery disease: Comparison with 3T-MRI[J]. AJR, 2010, 195(3): 639-646.
[19]de Roos A. Myocardial perfusion imaging with multidetector CT: beyond lumenography[J]. Radiology, 2010, 254(2): 321-323.