负荷动态CT心肌灌注成像在冠心病患者诊治中的应用  

Application of Load Dynamic CT Myocardial Perfusion Imaging in the Diagnosis and Treatment of Patients with Coronary Heart Disease

作　　者：杨剑锋 杨剑清 林伟添[2] 夏占统 YANG Jian-feng;YANG Jian-qing;LIN Wei-tian(Department of Imaging,Cadre Sanatorium of Guangdong Province,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]广东省干部疗养院影像科,广东广州510000 [2]广州医科大学附属第三人民医院,广东广州510000 [3]广东省深圳市人民医院,广东广州518000

出　　处：《中国CT和MRI杂志》2020年第6期70-72,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨负荷动态CT心肌灌注成像(CT-MPI)在冠心病患者诊治中的应用价值。方法选取2018年1月~2019年5月与我院收治的疑似或确诊为冠心病的患者30例,均行负荷动态CT-MPI和负荷单光子发射计算机断层成像(SPECT)-MPI检查。以SPECT-MPI检查为参照,比较灌注正常组和灌注异常组心肌血流量(MBF)、心肌血容量(MBV)、达峰时间(TTP)等指标差异性,在患者、血管区、心肌节段基础上评估CT-MPI诊断心肌缺血的敏感度、特异度及准确性,用Kappa检验评估两种检查方法的一致性。结果灌注异常组MBF、MBV低于灌注正常组,TTP高于灌注正常组(P<0.05);在患者、血管、心肌节段水平上,CT-MPI诊断心肌缺血的敏感度分别为93.33%、94.12%、95.24%,准确性分别为73.33%、83.33%、92.35%,Kappa值分别为0.467、0.667、0.788,两种诊断方法具有较高的一致性。结论负荷动态CTMPI可定量分析心肌血流灌注情况,对冠心病心肌缺血的诊断价值较高,具有良好的应用前景。Objective To explore the application value of load dynamic CT myocardial perfusion imaging(CT-MPI) in the diagnosis and treatment of patients with coronary heart disease. Methods Thirty patients with suspected or diagnosed coronary heart disease admitted to our hospital from January 2018 to May 2019 were selected. Load dynamic CT-MPI and single photon emission computed tomography(SPECT)-MPI were performed on patients. The SPECT-MPI examination was used as a reference to compare the differences of myocardial blood flow(MBF), myocardial blood volume(MBV) and time to peak(TTP) between normal perfusion group and abnormal perfusion group, and the sensitivity, specificity and accuracy of CT-MPI in the diagnosis of myocardial ischemia were evaluated based on patients, vascular regions, and myocardial segments, and the Kappa test was used to evaluate the consistency of the two examination methods. Results The MBF and MBV in abnormal perfusion group were lower than those in normal perfusion group while the TTP was higher than that in normal perfusion group(P<0.05). At the levels of patients, blood vessels and myocardial segments, the sensitivities of CT-MPI in the diagnosis of myocardial ischemia were 93.33%, 94.12% and 95.24% respectively, and the accuracies were 73.33%, 83.33% and 92.35%, and Kappa values were 0.467, 0.667 and 0.788 respectively. The two diagnostic methods had high consistency. Conclusion Load dynamic CT-MPI can quantitatively analyze myocardial perfusion, and has a high diagnostic value on myocardial ischemia in coronary heart disease. It has a good application prospect.

关 键 词：负荷动态CT心肌灌注成像 冠心病 心肌血流量 心肌血容量 达峰时间 

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