双能量CT心肌灌注成像冠状动脉迂曲与心肌碘含量的相关性研究  

Coronary tortuosity and myocardial iodine content with dual-energy CT myocardial perfusion imaging

作　　者：魏淼[1] 王思杭 温家华[1] 刘洋[1] 吕发金[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《临床心血管病杂志》2015年第11期1202-1206,共5页Journal of Clinical Cardiology

基　　金：国家临床重点专科建设项目(国卫办医函[2013]544号)

摘　　要：目的:探讨双能量CT心肌灌注成像冠状动脉(冠脉)迂曲与心肌碘含量的相关性。方法:连续收集98例心绞痛的患者行双能量CT心肌灌注成像,后处理获得冠脉CTA、心肌碘分布伪彩图和混合能量120kV灰度图。按照标准的冠脉15段、心肌17段分段法,计数冠脉迂曲段数,计算冠脉迂曲指数(TI),测量心肌碘含量、CT值,分析冠脉迂曲组与非迂曲组的心肌碘含量差异,冠脉迂曲与心肌碘含量的相关性。结果:冠状动脉迂曲组共58例,迂曲血管502段,其中93.23%无狭窄。迂曲血管的分布比率:左前降支或对角支占60.96%,回旋支占23.51%,右冠脉占15.53%;冠脉迂曲数目1 104个,平均迂曲弧度(109.08±20.9)°。非迂曲组40例;迂曲组的平均迂曲指数(TI=1.51±0.14)大于非迂曲组(TI=1.21±0.04),无狭窄的冠脉支配的心肌平均碘含量和平均CT值[(-1.04±0.38)mgI/g,(63.84±7.92)HU]均低于非迂曲组[(4.52±0.21)mgI/g,(98.55±6.41)HU],两组间迂曲指数(t1)、碘含量(t2)、CT值(t3)差异均有统计学意义(t1=23.1,t2=-3.03,t3=7.28,P=0.000);心肌碘含量与冠脉迂曲指数呈明显负相关(R=-0.86,P=0.000);迂曲组中伴发心绞痛者(X21)96.55%,左室心功能下降者(X22)72.41%,ST段异常者(X23)82.76%,与非迂曲组间差异有统计学意义(X21=20.47,X22=15.35,X23=15.32,P=0.000)。结论:冠脉迂曲好发于左前降支及对角支,较少合并狭窄;无狭窄的冠脉迂曲程度与心肌碘含量呈明显负相关,心肌供血减少。Objective：To investigate the correlation between coronary tortuosity and myocardial iodine content by dual-energy CT myocardial perfusion imaging.Method：The 98patients（male 48/female 50）with angina were carried out dual-energy CT myocardial perfusion imaging continuously.Polytype reconstruction images of coronary artery CT angiography,iodine distribution color map of myocardium and grey-scale map of polychromatic energy120 kV were obtained by post-processing workstation.The tortuous segments number and tortuous index（TI）of coronary arteries,myocardial iodine content and CT value at 15 coronary artery segments and 17 myocardial segments by criterion were measured.The difference of myocardial iodine content between coronary artery tortuosity group and non-tortuosity group was compared,and the correlation of coronary artery tortuosity and myocardial iodine content was analyzed.Result：Tortuousity group included 58 cases,of which 502 segments were tortuous vessels.The 93.23% of tortuous vessels were no stenosis.The distribution ratios of tortuous vessels：60.96% occurred in left anterior descending branch and diagonal branch,23.51% were in circumflex branch,and another 15.53% were in right coronary branch.The tortuousity number were 1104,and mean tortuous angle was（109.08±20.9）°.While another 40 cases composed non-tortuousity group.The mean TI of tortuousity group（1.51±0.14）was larger than non-tortuousity group（1.21±0.04）,while myocardial iodine content and CT value of myocardium supplied by tortuous coronary without stenosis（-1.04±0.38 mgI/g,63.84±7.92HU）were both smaller than non-tortuousity group（4.52±0.21mgI/g,98.55±6.41HU）.There were significant statistic differences of TI（t1）,iodine content（t2）and CT value（t3）between the two groups（t1=23.1,t2=-3.03,t3=7.28,P=0.000）.The correlation between myocardial iodine content and TI of coronary tortuosity was significantly negative（R=-0.86,P=0.000）.The 96.55% and 82.76% patients in tortuous group respectively co

关 键 词：双能量CT心肌灌注成像 冠状动脉迂曲 心肌碘含量 

分 类 号：R541.4[医药卫生—心血管疾病]