动态容积CT腺苷负荷心肌灌注成像诊断的探讨

An investigation for diagnosis value of DVCT-MPI with adenosine load

目的:评价动态容积CT(DVCT)腺苷负荷心肌灌注成像用于由冠状动脉管腔严重狭窄引起的可逆性心肌灌注缺损(MPD)诊断的可行性和准确性。方法:选取30例采用CT血管成像(CTA)检查诊断的冠心病患者,分别采集其静息状态和腺苷负荷状态下DVCT心肌灌注图像(MPI)进行对照研究,负荷和(或)静息灌注图像中MPD区与狭窄冠状动脉的供血区域进行比较。结果:对30例患者的480个心肌节段进行分析,负荷灌注检测心肌缺血节段的灵敏度、特异度和准确率分别为89.8%、89.5%和79%,而静息灌注检测心肌缺血节段的灵敏度、特异度和准确率分别为75%、91.8%和76%。负荷心肌灌注成像检出心肌灌注减低节段的灵敏度和准确度均高于静息心肌灌注成像。结论:在冠心病患者中,负荷心肌灌注成像可以更有效和准确地检出隐匿性心肌缺血。

Objective： To evaluate the feasibility and accuracy of dynamic volume computed tomography-myocardial perfusion imaging（DVCT-MPI） with adenosine load in the diagnosis for myocardial perfusion defection（MPD） with reversibility that was caused by serious narrow of coronary artery lumen. Methods： Thirty patients with coronary heart disease（CHD） confirmed by computed tomography angiography（CTA） were selected in this research. And their DVCT-MPI under resting state and adenosine load state were respectively collected, and then were implemented control study. And the MPD region and blood-supply region of narrow coronary artery between MPI with adenosine load state and（or） MPI with resting state were compared. Results： The 480 myocardial segments of 30 patients were analyzed. The detection sensitivity, specificity and accuracy of MPI with adenosine load were 89.9%, 89.5% and 79%, respectively. While the sensitivity, specificity and accuracy of MPI with resting state in the detecting segments of myocardial ischemia were 75%, 91.8% and 76%. The sensitivity and accuracy of MPI with adenosine load in finding the reduced segments of myocardial perfusion were higher than that of MPI with resting state. Conclusion： For patients with CHD, the silent myocardial ischemia can be more effectively and accurately found out by using MPI with adenosine load.