64层螺旋CT延迟扫描对心肌存活性的诊断价值：与^18F-FDG PET显像对比研究  

Delayed-enhancement in assessment of myocardial viability with 64-slice computed tomography,compared with ^(18)F-FDG PET imaging

作　　者：閤谦[1] 田建明[2] 汪斌[3] 孔令山[3] 崔斌[4] 吴骋[5] 陈涛[1] 童林军[1] 

机构地区：[1]上海交通大学附属仁济医院PET/CT中心,上海200240 [2]第二军医大学附属长海医院放射科,上海200433 [3]第二军医大学附属长海医院医教部,上海200433 [4]第二军医大学附属长海医院核医学科,上海200433 [5]第二军医大学统计教研室,上海200433

出　　处：《中国医学影像技术》2009年第2期301-304,共4页Chinese Journal of Medical Imaging Technology

基　　金：上海市领军人才培养基金(LJ06006)。

摘　　要：目的以^(18)F-FDG PET心肌代谢显像为标准,评价64层螺旋CT心脏延迟增强扫描对心肌存活性的诊断价值。方法20例急性心肌梗死患者,初次心肌梗死发作2周内接受64层螺旋CT及PET检查。按照美国心脏学会推荐的方法将左心室心肌分为17节段。逐个节段进行对比并用配对McNemar检验及诊断试验一致性检验进行统计分析,了解两种方法的一致性。结果左心室心肌的17个节段中,5段心肌两种方法检测结果完全一致。10段心肌一致性好(Kappa值>0.75),2段检测结果显示两种方法一致性较好(0.40≤Kappa值≤0.75)。结论64层螺旋CT心脏延迟增强扫描与PET评估心肌存活性具有很好的一致性,是一种有临床应用前景的评估存活心肌的新方法。Objective To assess the diagnostic value of myocardial viability by delayed-enhancement 64-slice CT compared with ^（18）F-FDG PET imaging in patients with acute myocardial infarction.Methods Twenty patients with first acute myocardial infarction outbreak underwent delayed enhancement multi-slice computed tomography（DE-MSCT）and ^（18）F-FDG PET image within two weeks.The 17 segments of the left ventricle depicted by the American Heart Association were graded：no, subendocardial,or transmural hyperenhancement on DE-MSCT.No or subendocardial hyperenhancement were expected to reflect viability.In order to determine the agreement of two methods,data of 17 myocardial segments were analyzed respectively by McNemar test and Kappa test.Results All patients were in sinus rhythm.Myocardial infarction was anterior（n= 8）,anteroseptal（n=3）,inferior（n=9）.Analysis of assessment of myocardial viability revealed best agreement among 5 myocardial segments（Kappa=1）,better agreement among 10 myocardial segments（Kappa〉75）and good agreement between 2 myocardial segments（0.40≤Kappa≤0.75）.Conclusion There is high agreement between DE-MSCT and ^（18）F-FDG PET imaging in the diagnosis of acute myocardial infarction.DE-MSCT is a promising method for assessment of myocardial viability.

关 键 词：心肌活力 体层摄影术 发射型计算机 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学] R542.22[医药卫生—诊断学]