| 孙智超,杜国庆.MCE-NSS系统自动定量分析缺血再灌注大鼠存活心肌[J].中国医学影像技术,2020,36(4): |
| MCE-NSS系统自动定量分析缺血再灌注大鼠存活心肌 |
| Automatic quantitative assessment of viable myocardium after ischemia-reperfusion using MCE-NSS system |
| 投稿时间：2019-12-25 修订日期：2020-04-13 |
| DOI： |
| 中文关键词: 超声心动图 心肌声学造影 缺血再灌注 中智相似积分 计算机辅助 |
| 英文关键词:Echocardiography Myocardial contrast echocardiography Ischemia-reperfusion Neutrosophic similarity score Computer-aided |
| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
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| 中文摘要: |
| 目的 探讨基于中智相似积分（NSS）算法的心肌超声造影（MCE）分析系统自动定量评估缺血再灌注大鼠存活心肌的准确性及应用价值。 方法SD大鼠制成心肌缺血再灌注(I/R)模型，随机分为缺血30min再灌注组（I/R-30组）与缺血45min再灌注组（I/R-45组）。分别于术前、阻断即刻、再灌注后7d、14d及28d行心肌超声造影（MCE）获取左室短轴（乳头肌水平）切面图像，运用MCE-NSS系统自动勾勒心内膜及心外膜边界，并将心肌均分为18个节段，获得各心肌节段室壁增厚率（WT）及标化造影剂灌注强度（CI）值。阻断即刻，将室壁收缩运动减弱或消失节段（WT＜0.3）定义为危险节段；再灌注后危险节段被划分为三个区域：①WT<0.3且CI＜-54 Pix为危险中央区；②WT<0.3且CI＞-54Pix为危险周边区域；③WT>0.3且CI>-54Pix为危险恢复区；观察阻断即刻、术后7d、14d和28d时中央区、周边区和恢复区面积变化情况。术后28d取大鼠心脏，行Masson染色及免疫组化分别计算梗死面积和微血管密度，并与MCE-NSS系统测得的梗死面积行相关性分析。结果 ①危险节段各区域面积变化：术后7d、14d和28d时，两组危险中央区面积百分比变化较阻断即刻变化不明显（P＞0.05），而危险周边区面积逐渐减小（P＜0.01），危险恢复区面积逐渐增加（P＜0.01）；I/R-45min组危险中央区面积在各时间点均大于I/R-30min组（P＜0.01），危险周边区和危险恢复区面积在两组间比较差异无统计学意义（P＞0.05）；②与病理结果比较：危险中央区面积和Masson染色计算的梗死面积呈正相关（r=0.81, P＜0.01），危险周边区CI值与免疫组化计算的微血管密度呈正相关（r=0.86, P＜0.01）。 结论 新型MCE-NSS系统可以实现对心肌缺血再灌注后左室局部收缩功能及微循环情况的评估，并能识别存活心肌。 |
| 英文摘要: |
| Objective To evaluate the accuracy and value of automatic quantitative assessment for viable myocardium after ischemic-reperfusion(I/R) using myocardial contrast echocardiography (MCE) based on neutrosophic similarity score(MCE-NSS) system. Methods SD rats were divided into occluding the left anterior descending coronary artery for 30 min followed by reperfusion (I/R-30) and for 45 min followed by reperfusion (I/R-45). MCE was performed before and immediate, 7 and 28 days after surgery. The left ventricular myocardium was divided into 18 segments, and the standardized contrast intensity (CI) and wall thickness (WT) of each myocardial segment were automatically calculated using the MCE-NSS system after identifying the endocardial and epicardial boundary. The segments with WT <0.3 were considered as the dangerous segments during occlusion, and then the dangerous central region (WT<0.3 and CI<-54 Pix), peripheral region (WT<0.3 and CI>-54 Pix) and recovered region (WT>0.3 and CI>-54 Pix) were defined by MCE-NSS system after reperfusion. Hearts were excised at 28 days after I/R, and myocardial sections were stained with Masson’s trichrome, as well as immunohistochemical staining of factor VIII, for histological examination. Results (1)There was not significantly changed in the dangerous central region of the two groups between at immediate and after reperfusion (P>0.05), however the dangerous peripheral region gradually decreased and the recovered region gradually increased at 7d, 14d and 28d after reperfusion(P <0.01). The area of the dangerous central region in I/R-45min group was significantly larger than that in I/R-30min group(P <0.01), but there was no significant difference in the dangerous peripheral and recovered region between the two groups(P> 0.05); (2)The area of the dangerous central region correlated positively with infarct size calculated by Masson staining (r = 0.81, P <0.01), and the CI value of the dangerous peripheral region was positively correlated with the microvascular density obtained by immunohistochemistry (r = 0.86, P <0.01). Conclusion The regional systolic function and microcirculation in left ventricle after I/R can be automatically quantitatively assessed, and then the viable myocardium can be identified by the MCE-NSS system. |
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