负荷心肌灌注显像与双源CT冠脉成像诊断冠心病的对比研究  

Stress myocardial perfusion imaging and dual-source CT coronary angiography in the diagnosis of coronary artery disease

作　　者：禹晖[1] 张金赫[1] 尹吉林[1] 

机构地区：[1]广州军区广州总医院核医学科,广州510010

出　　处：《放射学实践》2011年第12期1320-1322,共3页Radiologic Practice

摘　　要：目的:通过对心肌灌注显像(MPI)与心脏双源CT(DSCT)检查结果进行对比分析,探讨两者对冠心病的临床诊断价值。方法:对38例拟诊为冠心病的患者行MPI及心脏DSCT检查;分别对MPI图像及DSCT图像进行分析处理,其中29例经冠状动脉造影(CAG)证实为冠心病。结果:DSCT显示有29例冠脉狭窄程度>50%,其中大部分为75%～90%,其次为50%～74%,90%以上的较少。病变部位以左冠脉占绝大多数,其中以前降支较多;与冠状动脉造影结果基本一致,DSCT诊断阳性率为76.3%。MPI显示病变区心肌缺血改变38例,MPI心肌血流灌注减低与DSCT显示冠脉狭窄程度>50%符合21例。检查的灵敏度为97.3%(37/38),符合率为55.3%(21/38)。结论:MPI具有高度敏感性,可以作为冠心病检查的筛选手段,了解心肌缺血部位和范围。MPI结果阳性者可以进一步做DSCT或CAG检查;MPI结果阴性者,则不必做DSCT或CAG检查。Objective：MPI and DSCT coronary angiography results were analyzed to explore their clinical value in the diagnosis of coronary artery disease.Methods：38 patients with suspected coronary artery disease underwent MPI and cardiac DSCT coronary angiography,the MPI images and DSCT images were processed and analyed respectively;of which 29 patients were confirmed to suffer from coronary heart disease by coronary angiography.Results：DSCT showed 29 cases to have coronary stenosis,among them a greater part of cases to have stenosis from 75% to 90%,next from 50% to 74%,just a few above 90%.As to the lesion sites,the left coronary artery accounted for the vast majority with left anterior descending artery as the main part.DSCT diagnostic positive rate was 76.3%,being in agreement with those of coronary angiography.MPI displayed changes in the lesions of 38 cases of myocardial ischemia,reduction of myocardial perfusion and correspondence in coronary artery stenosis with DSCT 50% found in 21 cases,diagnostic positive rate was 55.3%.The sensitivity of SPECT was 97.3%（37/38）,accuracy was 55.3%（21/38）.Conclusion：MPI has a high degree of sensitivity,it can be used as a means of examination for coronary artery disease screening to understand the location and extent of myocardial ischemia.Patients with MPI positive results can be further examined by DSCT or CAG;in patients with negative results,further check is unnecessary.

关 键 词：心肌灌注显像 双源CT 冠状动脉 血管造影 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]