负荷心肌灌注显像结合双源CT冠状动脉成像预测冠状动脉介入疗效的临床价值

Usefulness of MPI Combined with SDCT Coronary Artery Imaging for Predicting Clinical Effect of Coronary Artery Intervention Therapy

目的探讨MPI结合DSCT心脏检查在预测冠状动脉介入治疗(冠状动脉支架置入术)疗效方面的价值。方法 28例接受经皮冠状动脉支架置入术的冠心病患者均在支架置入术前l周及随访期内完成MPI和DSCT检查,比较术前及术后MPI和DSCT定性和定量分析的结果。结果支架置入前SDCT及CAG显示病变狭窄部位以左冠状动脉占绝大多数,为33处,其中以前降支较多,为24处;右冠状动脉13处,与冠状动脉造影结果基本一致;支架置入前后比较冠脉狭窄有明显改善,有统计学差异(p<0.01)。MPI提示支架置入术后缺血心肌节段数明显少于术前,梗死心肌节段数则无显著差异。支架置入术后总负荷评分和负荷静息评分差值较术前明显降低;支架置入术后与术前相比,LEVEF明显升高,左室舒张末容积和左室收缩末容积均明显降低(p<0.01)。结论术前行MPI结合DSCT,不仅可以准确判断冠脉狭窄的部位、数量及程度;而且能够判断缺血存活心肌的情况,可以对支架置入术的疗效进行准确的预测,具有重要临床价值。

Objective To investigate the clinic value of using stress myocardial perfusion imaging combined with dual source CT coronary artery imaging to predict effect of percutaneous coronary intervention（stent implantation）.Methods 28 patients of CAD with stent implantation underwent MPI before（1 week）and after PCI procedure respectively and the results of MPI and DSCT were compared.Results Before stent implantation of SDCT and CAG showed the stenosis lesions in left coronary artery accounted for the majority, 33, of which the anterior descending branch more, 24; right coronary artery in 13, consistent with the results of coronary artery angiography. Before and after the implantation of stents, coronary stenosis is improved obviously. The amount of segments of ischemic myocardium after PCI was less than those before PCI significantly and the segments of infarct myocardium were similar. The values of SSS and SDS after PCI were lower than those before PCI significantly. After stent implantation the value of LVEF was higher, while the values of IVEDV and LVESV were lower rather than those before PCI. Conclusion MPI combined with SDCT has important clinical value to predict the effect of PCI.