CT冠状动脉成像腔内强化梯度与心肌首过灌注成像的初步研究  

Initial Study of Transluminal Attenuation Gradient and First-Pass Myocardial Perfusion in Coronary Computed Tomography Angiography

作　　者：陆静[1,2] 喻杰[1] 崔越[1] 胡元楠 刁楠[1] 梁波[1] 史河水[1] 韩萍[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022 [2]厦门大学附属中山医院核医学科,361004

出　　处：《临床放射学杂志》2016年第6期876-881,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81271570)

摘　　要：目的初步评估不同狭窄程度左前降支腔内强化梯度与相应冠状动脉供血区心肌首过灌注表现及其相关性。方法搜集CT冠状动脉成像诊断前降支狭窄病例52例(狭窄<50%组及狭窄≥50%组)与无狭窄病例20例(对照组),分别测量并计算前降支供血区心肌首过灌注值及其校正值、前降支腔内强化梯度及其校正值,进行统计学分析。结果 (1)狭窄组和对照组在收缩期、舒张期前降支腔内强化梯度校正值及供血区心肌首过灌注值差异均无统计学意义(均P>0.05);而首过灌注校正值差异均有统计学意义(均P<0.05)。(2)狭窄<50%组、狭窄≥50%组和对照组三组间在收缩期、舒张期前降支腔内强化梯度校正值及供血区心肌首过灌注值差异均无统计学意义(均P>0.05)。(3)狭窄<50%组和对照组在收缩期心肌首过灌注校正值差异无统计学意义(P>0.05),在舒张期差异有统计学意义(P<0.05);狭窄≥50%组与狭窄<50%组、狭窄≥50%组与对照组在收缩期、舒张期心肌首过灌注校正值差异分别具有统计学意义(均P<0.05)。结论心肌首过灌注校正值更能客观反映相应冠状动脉供血区的心肌血流灌注情况;腔内强化梯度校正值不能有效预测心肌缺血。Objective To preliminary evaluate the correlation between transluminal attenuation gradient in left anterior descending artery stenosis and the first pass myocardial perfusion.Methods 52 cases diagnosed stenosis（stenosis≥50%group and stenosis 50% group） and 20 normal cases on Coronary computed tomography angiography were enrolled.The first-pass myocardial perfusion CT value and the corrected myocardial perfusion,transluminal attenuation gradient and corrected contrast opacification were calculated.Results（1） There were no significant difference in transluminal attenuation gradient corrected contrast opacification and myocardium CT value between stenosis group and normal group in systole and diastole（P 〈0.05）; but there was significant difference in corrected myocardial perfusion（P 〈0.05）.（2） There was no significant difference of transluminal attenuation gradient corrected contrast opacification and myocardium CT value among stenosis 50% group,stenosis≥50% group and normal group in systole and diastole（P 〈0.05）.（3） There was no significant difference of corrected myocardial perfusion between stenosis 50% group and normal group in systole（P 〈0.05）,but there was significant difference in diastole（P 〈0.05）.There were significant differences of corrected myocardial perfusion between stenosis≥50% group and normal group,stenosis≥50% group and stenosis 50% group in systole and diastole（P 〈0.05）.Conclusion Measuring the systolic and diastolic corrected myocardium CT value of the patients with stenosis can evaluate the blood supply to a certain extent.But corrected contrast opacification could not detect myocardial ischemia.

关 键 词：双源CT 冠状动脉CT血管成像 腔内强化梯度 心肌首过心肌灌注 

分 类 号：R816.2[医药卫生—放射医学]