Master of Science
Hospitalization and revascularization treatment for patients with acute myocardial infarction (AMI) is an economic burden that can be minimized by identifying patients most likely to benefit. To this end, a non-invasive imaging technique to better characterize myocardial salvage may be helpful. In this thesis work, a functional CT technique is examined to assess at-risk, infarcted, and salvageable myocardial tissue. Data was acquired on a cohort of seven pigs with induced AMI during the acute and sub-acute phases post insult. The tracer kinetic model dependent CT images were validated against both T2-TIRM images and quantitative T1-maps acquired using MRI, as well as constant infusion CT images. Extravascular contrast distribution volume (ECDV) and myocardial perfusion (MP) parameters were used to characterize the injured myocardium. Derived ECDV and MP threshold for acute phase MI in seven pigs is 0.36 ml/g and 0.44 ml/min/g, respectively. Average MP in normal, at-risk and infarcted myocardium were 0.92 0.27, 0.80 0.19, 0.30 0.08 ml/min/g, respectively. Average ECDV in normal, at-risk, and infarcted myocardium were 0.13 0.08, 0.21 0.07, 0.60 0.12 ml/g, respectively. Significance was demonstrated in both MP and ECDV measurements between infarcted myocardium and myocardium atrisk, as well as between infarcted and normal myocardium (p< 0.01). Based on the area estimated using ECDV and MP, at-risk, infarcted, and salvageable myocardial tissue can be delineated.
Hur, Lisa Yun Jeong, "Functional CT Imaging for Myocardial Salvage in Acute Myocardial Infarction Management" (2018). Electronic Thesis and Dissertation Repository. 5538.