摘要目的:探讨多模态影像技术评价山羊动物模型冠状动脉微循环障碍（CMD）的价值。方法:雌雄不限，按5~8月龄随机挑选实验用萨能奶山羊10只。麻醉后经股动脉选择性插管，于不同分支冠状动脉远端缓慢注入1 ml单分散聚苯乙烯微球混合液（含微球计数约1.14×10 6/ml），建立CMD动物模型。成功建模7 d后行双能量CT心肌灌注成像（DECT-MPI）、SPECT心肌灌注成像（SPECT-MPI）、PET心肌灌注成像（PET-MPI）、心脏MR心肌灌注成像（CMR-MPI）影像学检查，之后处死实验动物行心肌组织病理学检查。以组织病理学为金标准，评估几种影像学方法评价CMD的灵敏度、特异度、阳性预测值、阴性预测值及准确度。应用ROC曲线评估几种影像学方法诊断CMD的价值。 结果:10只实验动物，3只死亡，其余7只成功完成造模并进行了影像学检查。组织病理学共评估119个心肌节段，证实有缺血心肌节段18个，正常心肌节段101个。以病理学为金标准，DECT-MPI、SPECT-MPI、PET-MPI诊断CMD的灵敏度、特异度分别为55.56%、98.02%，66.75%、98.83%，93.75%、97.68%；因MR检查操作时间长，要求麻醉时间长，仅有1只实验动物顺利完成了CMR-MPI检查，准确度为88.24%。结论:本研究提供了一种无创影像学评估CMD的大型动物建模方法。DECT-MPI、SPECT-MPI、PET-MPI、CMR-MPI在评估CMD具有较好的效能，几种无创影像学方法评估CMD各有优缺点。

abstractsObjective:To explore the value of multimodal imaging for evaluation on coronary microcirculation disorders in a goat animal model of CMD.Methods:Ten Saanen dairy goats age of 5-8 months were randomly selected in this experimental study. After anesthesia, a 1.9-F micro guide wire was introduced via a percutaneous direct puncture through superficial femoral artery. Then, 1 ml of monodisperse polystyrene microsphere mixture, which contained 1.14×10 6/ml of microsphere, was slowly injected into the distal end of branch coronary to establish a CMD animal model. DECT-MPI, SPECT-MPI, PET-MPI, CMR-MPI imaging examinations were performed 7 days after the establishment of CMD model. The animals were sacrificed for myocardial histopathological examination after the imaging examination. Using histopathology as the standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the DECT-MPI, SPECT-MPI, PET-MPI, CMR-MPI imaging were evaluated. The ROC curve is used to evaluate the value of the imaging methods in the diagnosis of CMD. Results:Of the 10 experimental animals, three goats died, and CMD model was successfully established in 7 goats. A total of 119 myocardial segments were evaluated on histopathology, of which, 18 myocardial segments were confirmed ischemic myocardial segments and 101 myocardial segments were normal. Taking the results of pathology as standard, the sensitivity and specificity of DECT-MPI, SPECT-MPI, PET-MPI in diagnosing CMD were 55.56% and 98.02%, 66.75% and 98.83%, 93.75% and 97.68%, respectively. Due to the long operation time of MRI and the requirement of longer anesthesia time, only one experimental animal successfully completed the MR examination with the accuracy rate of 88.24%.Conclusions:Our experimental study provides a goat model of CME using monodisperse polystyrene microsphere mixture injection resembling the clinical scenario of CME. DECT-MPI, SPECT-MPI, PET-MPI and CMR-MPI showed good performance for evaluation on CMD, with different advantages and limitations for each modality.