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首页> 美国卫生研究院文献>Comparative Medicine >Assessment of Semi-automated Computed Tomographic Measures of Segmental Perfusion Defects in a Swine Model (Sus scrofa) of Intermediate Coronary Lesions
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Assessment of Semi-automated Computed Tomographic Measures of Segmental Perfusion Defects in a Swine Model (Sus scrofa) of Intermediate Coronary Lesions

机译：中间冠状病变中猪型（SUS Scrofa）中分段灌注缺陷的半自动计算断层测量评估

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Computed tomographic myocardial perfusion (CTP) imaging is a tool that shows promise in emergent settings for defining the hemodynamic significance of coronary artery disease. In this study, we examined the accuracy with which the transmural perfusion ratio (TPR) derived through semiautomated CTP analysis reflected segmental perfusion defects associated with intermediate coronary artery lesions in swine. Lesions (diameter stenosis, 65% ± 11%) of the left anterior descending coronary artery (LAD) were created in 10 anesthetized female swine (weight, 47.5 ± 1.9 kg) by using a pneumatic occlusion device implanted on the LAD. Occluder inflation pressures were adjusted to maintain fractional flow reserve (FFR, 74.3 ± 1.7) during adenosine infusion (140ug/kg/min). Static CTP imaging using a stress-rest protocol and segmental TPR derived from semiautomated CT perfusion software was compared with microsphere-derived TPR (mTPR) by using a 16-segment model and polar mapping. Intermediate LAD stenosis was verified through multiplanar coronary CT angiography. Receiver operating characteristic analysis identified an optimal threshold for segmental perfusion defects for intermediate lesions (TPR threshold, ≤0.80); however, the area under the receiver operating characteristic curve was 0.58, and the overall accuracy was 63%. At this threshold, the sensitivity and specificity were 65% and 61%, and the positive and negative predictive values were 61% and 65%, respectively. Although CTP–TPR illustrated segmental perfusion defects with intermediate lesions, the disparity between CTP–TPR and mTPR measures of segmental perfusion suggests that further advances in analysis software may be necessary to improve the localization of segmental defects for intermediated lesions.
机译：计算的断层摄影心肌灌注（CTP）成像是一种工具，其在突出设置中显示出冠状动脉疾病血流动力学意义的承诺。在这项研究中，我们检查了通过半归类CTP分析来源的透射灌注比（TPR）的准确性反映了与猪中中间冠状动脉病变相关的节段性灌注缺陷。左前期下降冠状动脉（LAD）的病变（直径狭窄，65％±11％）在10个麻醉的雌性猪（重量，47.5±1.9千克）中，通过使用植入小管道的气动闭塞装置在10个麻醉的雌性猪（重量。调整封堵器膨胀压力以在腺苷输注（140ug / kg / min）期间保持分数流量储备（FFR，74.3±1.7）。使用16段模型和极性映射将使用从半算术CT灌注软件衍生的微球衍生的TPR（MTPR）进行静态CTP成像和衍生自半径的CT灌注软件的分段TPR。通过多平面冠状动脉CT血管造影验证中间小样狭窄。接收器操作特征分析确定了用于中间病变的节段性灌注缺陷的最佳阈值（TPR阈值，≤0.80）;然而，接收器操作特性曲线下的区域为0.58，总精度为63％。在该阈值下，敏感性和特异性分别为65％和61％，分别为61％和65％。尽管CTP-TPR所示的具有中间病变的节段性灌注缺陷，但是CTP-TPR和STM间灌注的MTPR测量之间的视差表明，可能需要进一步进展，以改善中间病变的节段性缺陷的定位。

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