Dual source dual energy CT of acute myocardial ischemic reperfusion injury: an experimental study in swine / 中华放射学杂志

ABSTRACT

ObjectiveTo investigate the feasibility and accuracy of dual energy CT (DECT) in detecting acute myocardial ischemic reperfusion injury in a swine model.Methods Acute myocardial ischemic reperfusion injury model was made by ligaturing the left anterior descending coronary artery (LAD)or the first diagonal artery ( D1 ) of swine heart,the first-pass contrast enhanced DECT was performed.And then pigs were sacrificed,and the hearts were removed,triphenyhetrazolium chloride staining was performed.The CT numbers of non-ischemic and ischemic regions were measured.In the short axis of the left ventricle,the ventricular wall was divided into 17 segments for analysis,segments with myocardial perfusion defect in DECT myocardial iodine maps,DECT ( 140,100 kV,weighted average 120 kV) were determined and compared with histopathology.The sensitivity,specificity and inter-modality agreement of DECT in detecting myocardial injury were calculated.One-way ANOVA test was used to analyze the differences between the CT number and weight of infracted myocardium measured on DECT at 140,100 kV,weighted average 120 kV in ischemic and normal regions.ResultsPartial sparse or defective perfusion in the apical anterior and septal wall were demonstrated in DECT myocardial iodine maps.The CT number of injured myocardium was significantly lower than that of normal myocardium at 140,100 kV,weighted average 120 kV.The sensitivity,specificity of DECT myocardial iodine maps were 85.2％ (23/27),86.2％ (94/109),and Kappa value was 0.62,the sensitivity,specificity at 140 kV were 88.9％ (24/27),92.7％ (101/109),and Kappa value was 0.76,the sensitivity,specificity at 100 kV were 85.2％(23/27),89.0％ (97/109),and Kappa value was 0.67,the sensitivity,specificity at weighted average 120 kV were 88.9％ (24/27),91.7％ ( 100/109),and Kappa value was 0.74.There were no significant differences between the weight of infracted myocardium measured on DECT at 140,100 kV,weighted average 120 kV and histopathological results ( F =0.419,P =0.741 ).ConclusionDECT myocardial iodine maps can detect acute myocardial ischemic reperfusion injury in a swine model and have a good correlation with histopathology.