SPECT/CT心肌灌注显像中低剂量衰减校正CT发现心外病变的价值  

Extracardiac findings by low dose CT attenuation correction during SPECT/CT myocardial perfusion imaging

作　　者：唐平[1] 赵艳军[1] 华茜[1] 倪建明[1] 

机构地区：[1]无锡市第二人民医院核医学科,214002

出　　处：《中华核医学与分子影像杂志》2018年第1期29-32,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨SPECT/CT心肌灌注显像中衰减校正用低剂量CT对心外病变的检出率及其临床意义。方法回顾性分析2014年7月至2016年2月期间因临床怀疑冠状动脉粥样硬化性心脏病或心肌病行心肌灌注显像的520例患者（男288例，女232例，平均年龄65.8岁）的资料，患者显像时图像的衰减校正用低剂量CT。分析患者CT图像，记录肺、纵隔、胸壁、大血管、脊柱以及部分上腹部脏器中出现的意外病变。对所有心外病变按照临床危险程度分为3组：需要立即进一步检查并采取治疗措施的A组，需要随访或进一步检查以确诊的B组，以及不需要进一步检查的C组。结果在52.31%（272/520）的患者中发现356处心外病变，其中A组24例（4.62%，24/520），B组105例（20.19%，105/520），C组143例（27.50%，143/520）。129例（24.81%，129/520）患者发现158处有临床意义的病变，包括新发现的5例（0.96%，5/520）恶性肿瘤。结论SPECT/CT心肌灌注显像中衰减校正用低剂量CT时心外病变的检出率较高，其可以发现一些具有重要临床意义的病变。ObjectiveTo investigate the value of CT in detecting incidental extracardiac findings （IEFs） when used for attenuation correction during SPECT/CT myocardial perfusion imaging （MPI）.MethodsA total of 520 patients （288 males, 232 females, average age 65.8 years） who underwent SPECT/CT MPI between July 2014 and February 2016 were retrospectively analyzed. Low dose CT attenuation correction was used during MPI. IEFs of lung, mediastinum and chest wall, large blood vessels, spine, and part of upper abdomen were recorded independently. All findings were divided into three categories： IEFs requiring further examination and treatment measures taken immediately （group A）, IEFs requiring follow-up or further examination （group B）, IEFs need no further treatment （group C）.ResultsIEFs （n=356） were observed in 52.31%（272/520） of the patients, with 24 cases in group A （4.62%, 24/520）, 105 cases in group B （20.19%, 105/520） and 143 cases in group C （27.50%, 143/520）. There were 158 clinically significant IEFs in 129 patients （24.81%, 129/520）, including 5（0.96%, 5/520） with newly diagnosed malignancy.ConclusionIEFs detected by CT used for attenuation correction during SPECT/CT MPI are not uncommon, including a few cases with clinically significant findings.

关 键 词：心肌灌注显像 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 

分 类 号：R541.4[医药卫生—心血管疾病] R542.2[医药卫生—内科学] R816.2[医药卫生—临床医学]