双源CT冠脉造影和SPECT对评估心肌灌注异常与冠脉狭窄的相关性分析

Value of Dual Source CT Coronary Angiography and SPECT in Assessing Myocardial Perfusion Abnormalities and Coronary Stenosis

目的分析双源CT冠脉造影和SPECT对评估心肌灌注异常与冠脉狭窄的相关性。方法筛选出36例拟诊或确诊的冠心病患者作为研究对象,对其行双源CT冠脉造影和SPECT心肌灌注显像,分析影像学检查结果,评价心肌灌注异常与冠脉狭窄的相关性。结果双源CT冠脉造影检查可评价的冠脉血管节段共446段,诊断为冠脉正常21例(403段),狭窄13例(40段),闭塞2例(3段)。SPECT心肌灌注显像检查,可评价的心肌节段共601段,诊断为心肌灌注正常27例(580段),心肌灌注异常9例(21段)。以SPECT心肌灌注显像为金标准,双源CT冠脉造影检出冠脉狭窄为50%时,检出心肌灌注异常的准确率、敏感性、特异度、阳性预测值、阴性预测值依次为85%、78%、87%、71%、91%。结论双源CT冠脉造影和SPECT心肌灌注显像诊断冠心病的应用价值高,对评估心肌灌注异常与冠脉狭窄的相关性具有非常重要的指导意义。

Objective To analyze the correlation between dual source CT coronary angiography and SPECT in evaluating myocardial perfusion abnormalities and coronary stenosis. Methods 36 patients with coronary heart disease were selected as the subjects. The two source CT coronary angiography and SPECT myocardial perfusion imaging were performed. The results of imaging examination were analyzed,and the correlation between myocardial perfusion abnormality and coronary stenosis was evaluated. Results A total of 446 segments of coronary artery segments were evaluated by dual source CT coronary angiography,and 21 cases（ 403 segments） were diagnosed as normal coronary artery,13 cases（ 40 segments） and 2 occlusion（ 3 segments）. A total of 601 segments of cardiac muscle segment were evaluated by SPECT myocardial perfusion imaging. 27 cases（ 580 segments） were diagnosed as normal myocardial perfusion and 9 cases（ 21 segments） were abnormal myocardial perfusion. With SPECT myocardial perfusion imaging as the gold standard,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of myocardial perfusion abnormalities were 85%,78%,87%,71% and 91% in the case of 50% coronary stenosis detected by dual source CT coronary angiography. Conclusions The dual source CT coronary angiography and SPECT myocardial perfusion imaging are of high value in the diagnosis of coronary heart disease. It is of great guiding significance for the evaluation of the correlation between abnormal myocardial perfusion and coronary stenosis.