Author + information
To evaluate the feasibility and accuracy of obtaining myocardial perfusion and coronary artery images in a pig model of acute myocardial infarction by “one-stop” scanning using second generation dual-source computed tomography (CT).
A porcine model of acute myocardial infarction was established using the interventional gelfoam embolism method in five pigs. Myocardial perfusion scanning and coronary angiography were used 20 mins before and 24-48 hrs after modeling, respectively. The hearts were explanted immediately after inspection for multiple punch biopsies and histolopathologic staining. Then, the hearts were sliced for triphenyltetrazolium chloride (TTC) staining to analyze the area of myocardial infarction pathologically. The left ventricular wall was divided into 17 segments to determine segment number and exact location of myocardial infarction as correlated by myocardial perfusion image reconstruction by myocardial perfusion scanning and pathological staining. The coronary artery was divided into 16 segments, and according to the results of coronary artery images, there were two types: stenosis of less than 50% and stenosis greater than or equal to 50%, regarded as positive. The consistency of the results was verified by the kappa test.
The reconstructed image by myocardial perfusion showed that the degree of filling of contrast agent for the myocardium in the area of the infarcted coronary artery significantly decreased, and that coronary blood flow in the infarcted portion was interrupted. Compared with the pathologic gold standard, the sensitivity, specificity, negative predictive value, and positive predictive value of iodine myocardial perfusion imaging obtained by myocardial perfusion scanning were 93, 91, 83, and 96%, respectively; the kappa value was 0.68. Compared with the coronary angiography gold standard, the sensitivity, specificity, negative predictive value, and positive predictive value of coronary artery imaging obtained by myocardial perfusion scanning were 93, 81, 95, and 75%, respectively; the kappa value was 0.71.
Second generation dual-source CT dual-energy myocardial perfusion “one-stop” scanning can accurately obtain coronary artery and myocardial perfusion images in a porcine model of acute myocardial infarction.