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首页> 外文期刊>Acta Radiologica >Acute myocardial infarct detection with dual energy CT: correlation with single photon emission computed tomography myocardial scintigraphy in a canine model.
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Acute myocardial infarct detection with dual energy CT: correlation with single photon emission computed tomography myocardial scintigraphy in a canine model.

机译：双能CT急性心肌梗死检测：与犬模型中单光子发射计算机断层扫描心肌闪烁显像的相关性。

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Dual-energy CT (DECT) has been used to detect myocardial infarct. However, few comparable studies with histopathological findings as gold standard have been published.To investigate the accuracy of DECT iodine maps for detecting acute myocardial infarction compared with single photon emission computed tomography (SPECT) in a canine model using histopathological findings as the reference standard.A model of myocardial ischemia was created by ligating the left anterior descending (LAD) coronary artery after thoracotomy in six dogs, while another three dogs undergoing thoracotomy without LAD ligature served as a control group. Contrast-enhanced DECT scans of the heart were performed, followed by resting 99mTc-MIBI SPECT myocardial perfusion imaging in all nine dogs before and 3 h after the procedure. Triphenyltetrazolium chloride (TTC) staining was performed and analyzed. In the short axis of the left ventricle, the wall surface was divided into 17 segments, which were assessed for infarcted myocardium on conventional CT from average-weighted data, DECT myocardial iodine maps, conventional CT plus DECT, SPECT, and histopathology. Inter-observer and inter-modality agreement for conventional CT, DECT myocardial iodine maps, and SPECT were calculated. CT value of infracted and non-infracted areas was measured.With the histopathological results as the reference standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 75.0% (30/40), 92.0% (104/113), 76.9% (30/39), 91.2% (104/114), 87.6% (134/153) for conventional CT, 85.0% (34/40), 84.1% (95/113), 65.4% (34/52), 94.1% (95/101), 84.3% (129/153) for DECT myocardial iodine maps; 87.5% (35/40), 92.9% (105/113), 81.4% (35/43), 95.5% (105/110), 91.5% (140/153) for conventional CT plus DECT; 82.5% (33/40), 90.3% (102/113), 75.0% (33/44), and 93.6% (102/109), 88.2% (135/153) for SPECT, respectively. Excellent inter-observer agreement (Kappa value >0.8) and good inter-modality agreement (Kappa value >0.6) for each modality were found. CT values of infarcted myocardium (26 ± 22 HU, 36 ± 33 HU, 34 ± 16 HU) were lower than those of non-infarcted myocardium (115 ± 16 HU, 121 ± 28 HU, 123 ± 11 HU) on images of 140 kVp, 80 kVp, and average-weighted 120 kVp images (all P < 0.05).With histopathology as the reference standard, DECT myocardial iodine maps can detect acute myocardial infarction with diagnostic accuracy comparable to resting SPECT myocardial perfusion imaging in a canine model. DECT plus conventional CT had a potential to improve the detection of acute myocardial infarction.
机译：双能CT（DECT）已用于检测心肌梗塞。然而，以组织病理学发现为金标准的可比较研究很少发表。以组织病理学发现作为参考标准，与单光子发射计算机断层扫描（SPECT）相比，DECT碘图在检测急性心肌梗死中的准确性要进行调查。通过在六只狗中开胸手术后结扎左前降支（LAD）冠状动脉来创建心肌缺血模型，而另外三只在没有LAD结扎的情况下进行开胸手术的狗作为对照组。进行对比增强的心脏DECT扫描，然后在手术前和手术后3小时对所有9只狗进行99mTc-MIBI SPECT心肌灌注成像静息。进行了三苯基氯化四唑（TTC）染色并进行了分析。在左心室的短轴上，将壁表面分为17个部分，根据平均加权数据，DECT心肌碘图，常规CT加DECT，SPECT和组织病理学对常规CT上的梗塞心肌进行评估。计算了常规CT，DECT心肌碘图和SPECT的观察者间和方式间的一致性。测量梗死区和非梗死区的CT值，以组织病理学结果作为参考标准，敏感性，特异性，阳性预测值（PPV），阴性预测值（NPV）和准确性为75.0％（30/40） ，常规CT的92.0％（104/113），76.9％（30/39），91.2％（104/114），87.6％（134/153），85.0％（34/40），84.1％（95/113） ），DECT心肌碘图的65.4％（34/52），94.1％（95/101），84.3％（129/153）;传统CT加DECT的87.5％（35/40），92.9％（105/113），81.4％（35/43），95.5％（105/110），91.5％（140/153）; SPECT分别为82.5％（33/40），90.3％（102/113），75.0％（33/44）和93.6％（102/109），88.2％（135/153）。对于每种方式，观察者之间的一致性极好（Kappa值> 0.8）和模态间良好的一致性（Kappa值> 0.6）。在140张图像上，梗死心肌的CT值（26±22 HU，36±33 HU，34±16 HU）低于未梗塞心肌的CT值（115±16 HU，121±28 HU，123±11 HU） kVp，80 kVp和平均加权的120 kVp图像（所有P <0.05）。以组织病理学为参考标准，DECT心肌碘图可检测出急性心肌梗塞，其诊断准确度可与犬模型中静息SPECT心肌灌注成像相媲美。 DECT加上常规CT可能会改善对急性心肌梗塞的检测。

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