title: Computed Tomography Perfusion Imaging Detection of Microcirculatory Dysfunction in Small Intestinal Ischemia-Reperfusion Injury in a Porcine Model.
abstract: OBJECTIVE
  To evaluate multi-slice computed tomography (CT) perfusion imaging (CTPI) for identifying microcirculatory dysfunction in small intestinal ischemia-reperfusion (IR) injury in a porcine model.
  
  
  METHODS
  Fifty-two pigs were randomly divided into 4 groups: (1) the IR group (n = 24), where intestinal ischemia was induced by separating and clamping the superior mesenteric artery (SMA) for 2 h, followed by reperfusion for 1, 2, 3, and 4 h (IR-1h, IR-2h, IR-3h, and IR-4h; n = 6, respectively); (2) the sham-operated (SO) group (n = 20), where the SMA was separated without clamping and controlled at postoperative 3, 4, 5, and 6 h (SO-3h, SO-4h, SO-5h, and SO-6h; n = 5, respectively); (3) the ischemia group (n = 4), where the SMA was separated and clamped for 2 h, without reperfusion, and (4) baseline group (n = 4), an additional group that was not manipulated. Small intestinal CTPI was performed at corresponding time points and perfusion parameters were obtained. The distal ileum was resected to measure the concentrations of malondialdehyde (MDA) and superoxide dismutase (SOD) and for histopathological examination.
  
  
  RESULTS
  The perfusion parameters of the IR groups showed significant differences compared with the corresponding SO groups and the baseline group (before ischemia). The blood flow (BF), blood volume (BV), and permeability surface (PS) among the 4 IR groups were significantly different. BF and BV were significantly negatively correlated with MDA, and significantly positively correlated with SOD in the IR groups. Histopathologically, the effects of the 2-h ischemic loops were not significantly exacerbated by reperfusion.
  
  
  CONCLUSIONS
  CTPI can be a valuable tool for detecting microcirculatory dysfunction and for dynamic monitoring of small intestinal IR injury.
authors.affiliation: Department of Radiology, Changzhou NO2 People's Hospital, Changzhou, Jiangsu 213000, China.|Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
authors.forename: Ruokun
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
authors.forename: Jinwei
authors.initials: J
authors.lastname: Qiang
authors.affiliation: Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Pathology, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Surgery, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.
authors.forename: Rongxun
authors.initials: R
authors.lastname: Sun
mesh_terms: D000818:Animals; D007421:Intestine, Small / Q000098:blood supply* / Q000473:pathology; D008833:Microcirculation; D055420:Perfusion Imaging; D015427:Reperfusion Injury / Q000000981:diagnostic imaging* / Q000473:pathology; D013552:Swine; D014057:Tomography, X-Ray Computed