摘要
目的探讨双源双能量CT心肌灌注成像对冠状动脉粥样硬化性心脏病（冠心病）的诊断价值。方法选择2013年12月~2016年1月间在南通大学附属海安人民医院心内科诊治的临床已知或疑似冠心病患者72例作为观察组，同期选择在我院进行体检的健康人72例作为对照组，两组都进行常规CT与双源双能量CT心肌灌注成像分析，同时观察组进行冠状动脉造影检查与相关性分析。结果所有受检者的CT图像质量均满足诊断要求，观察组72例中有65例共计135支冠状动脉出现不同程度的狭窄或闭塞，对照组中无检出冠状动脉狭窄情况。观察组舒张期与收缩期的CT值分别为（45.25±16.22)HU和（44.29±12.64)HU，都明显低于对照组的（107.39±18.98)HU和（101.48±18.22)HU，差异有统计学意义(P<0.05)。在观察组72例患者中，冠状动脉造影确诊为冠心病62例，其中轻度狭窄40例，中度狭窄20例，重度狭窄2例，为此双源双能量CT心肌灌注成像对冠心病的诊断敏感性与特异性为95.4%和100%;Spearman相关分析表明在观察组中，CT心肌灌注成像舒张期与收缩期的CT值与冠状动脉造影狭窄程度呈现明显负相关性（r=-0.563，-0.622,P<0.05)。结论双源双能量CT心肌灌注成像在冠心病患者中的应用可获得优良的冠状动脉和心肌灌注成像，具有较高诊断特异性、敏感性，能明显反映疾病状况，有很好的临床诊断价值。
Objective To discuss the value of dual-energy CT(DECT)myocardial perfusion imaging(MPI)in diagnosis of coronary heart disease(CHD).Methods The patients with diagnosed CHD or suspected CHDwere chosen as observation group and the subjects with physical examinations were chosen as control group(eachn=72)from the D epartm ent of Cardiology of H ai’an P eople’s Hospital affiliated to Nantong University fromDec.2013to Jan.2016.All groups were given routine CT and DECT-M PI examinations,and at the same timethe observation group was given coronary angiography(CAG)examination for correlation analysis.Results TheCT images quality of all cases met the diagnostic requirement.Of72patients in observation group,there were65(135coronary branches)with stenosis or occlusion in varying degrees,and there were no cases with stenosis incontrol group.In observation group,diastolic CT value was(45.25±16.22)HU and systolic CT value was(44.29土12.64)HU,which were significantly lower than those in control group[(107.39±18.98)HU,(101.48±18.22)HU,P<0.05].Among72patients in observation group,there were62diagnosed with CHD,and40with mild stenosis,20with moderate stenosis and2with severe stenosis.In the diagnosis of CHD,the sensitivity of DECT-M PI was95.4%and specificity was100%.Spearman correlation analysis showed that diastolic CT value and systolic CT中国循证心血管医学杂志2016年11月第8卷第11期Chin J Evid Based Cardiovasc M ed,Novem ber,2016,V ol.8,No.11?1351?value of DECT-M PI were negatively correlated to stenosis degree of coronary artery(r=-0.563,-0.622,P<0.05).Conclusion D ECT-M PI can obtain excellent images of coronary artery and m yocardial perfusion with higherspecificity and sensitivity,which can reflect disease status and has higher diagnostic values in clinic.
作者
刘思宏
刘孝臣
吴平
卢春雨
LIU S ihong;LIU Xiao-chen;WU Ping;LU Chun-yu(Department o f Roentgenology, Hai'an People's Hospital, Nantong University, Nantong 226600, China.)
出处
《中国循证心血管医学杂志》
2016年第11期1351-1353,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
双源双能量CT
心肌灌注成像
冠心病
特异性
敏感性
Dual-energy CT
Myocardial perfusion imaging
Coronary heart disease
Specificity
Sensitivity
