320层容积CT心肌灌注成像对心肌灌注缺损的诊断价值

Detection of myocardial perfusion defect with 320-row volume CT myocardial perfusion imaging

目的探讨320层容积CT心肌灌注成像（CT—MPI）的可行性及其对心肌灌注缺损的诊断价值。方法对14例经SPECT心肌灌注成像（SPECT—MPI）阳性的已知或可疑冠心病患者行静息和腺苷负荷320层容积CT—MPI检查，使用专用心肌灌注软件对CT—MPI进行分析。以心肌16节段标准分段方法（心尖除外）分别分析核素和容积CT—MPI的固定或可逆性灌注缺损。以SPECT—MPI为参考标准评价CT—MPI对心肌灌注缺损诊断的敏感度、特异度。结果所有患者均成功完成320层容积CT，MPI。SPECT—MPI显示14例患者中共有39段心肌出现固定或可逆性灌注缺损，CT—MPI正确显示了其中12例患者的34段心肌灌注缺损。320层容积CT—MPI诊断心肌灌注缺损的敏感度、特异度分别为87．2％（34／39）和91．4％（169／185）。结论320层容积CT—MPI对诊断心肌灌注缺损有较高的敏感度和特异度。

Objective To evaluate the feasibility of 320-row volume CT myocardial perfusion imaging （CT-MPI） in detecting myocardial perfusion defect. Methods Fourteen patients with positive single-positron emission computed tomography myocardial perfusion imaging （SPECT-MPI） findings underwent both rest and adenosine stress 320-row volume CT-MPI. Rest and stress CT perfusion images were analyzed by employing dedicated software in 320-row CT workstation. Both SPECT-MPI and CT-MPI were evaluated for fixed and reversible perfnsion defects using a 16-segment model （apex was excluded）. The sensitivity, specificity of 320-row volume CT-MPI in detecting myocardial perfusion defect were evaluated by taking SPECT-MPI as a reference standard. Results Both rest and stress 320-row volume CT-MPI were successfully performed in all patients. Thirty nine segments with fixed or reversible perfusion defects in all patients were depicted by SPECT-MPI, while 34 perfusion defects in 12 patients were identified by CT-MPI. The sensitivity, specificity of 320-row volume CT-MPI for detection of perfusion defects were 87. 2% （34/39）, 91.4% （169/185）, respectively. Conclusion 320-row volume CT-MPI has high sensitivity and specificity for detection of myocardial perfusion defects.