宝石能谱CT心肌灌注成像的初步研究

Application of Gemstone Spectrum CT in One-stop Examination in Coronary Heart Disease

目的:探讨宝石能谱CT一站式检查对冠状动脉狭窄以及心肌缺血的诊断价值。方法:收集2018年3月至2019年11月来我院就诊的34例冠心病患者(男23例,女11例),所有患者接受能谱模式冠状动脉CTA扫描,并在一周内行静息态核素-心肌灌注检查。应用后处理软件对灌注缺损中心区域与同层面灌注正常区域的碘含量、能谱曲线斜率等参数进行测定,并以SPECT为参考标准,应用Pearson’s相关分析评价能谱CT对心肌缺血的诊断效能。结果:对34例患者进行分析,冠脉中度以上狭窄节段占比79/544。能谱CT共检出心肌灌注缺损区域41个,SPECT发现灌注缺损区域33个,二者具有良好的相关性(r=0.979,P=0.04)。应用能谱CT测定灌注正常区域碘含量、能谱曲线斜率分别为(14.49±5.20)mg/mL、1.29±0.39;灌注异常区域碘含量、能谱曲线斜率分别为(-12.59±3.32)mg/mL、-0.98±0.35,两者差异有统计学意义(P <0.05)。结论:宝石能谱CT在评估冠状动脉狭窄的同时,通过首过灌注心肌碘含量分析,对评估心肌缺血有一定提示意义。

Objective:To explore the diagnostic value of gemstone spectrum CT for coronary artery stenosis and myocardial ischemia.Methods:A total of 34 patients with coronary heart disease(23 males and 11 females)who came to our hospital from March 2018 to November 2019 were collected.All patients underwent a CTA scan of the coronary spectrum CT,and were given a nuclide in a week-Myocardial perfusion examination.The post-processing software was used to determine the iodine content and the slope of the spectrum curve in the central region of perfusion defect and the normal region of perfusion at the same level,and SPECT was used as the reference standard to evaluate the diagnostic efficacy of spectrum CT for myocardial ischemia using Pearson’s correlation analysis.Results:Analysis of 34 patients showed that the proportion of stenotic segments above moderate coronary artery was 79/544.Spectrum CT detected 41 myocardial perfusion defect areas,and SPECT found 33 defect areas,and the two had good correlation(r=0.979,P=0.04).Spectrum CT was used to determine the iodine content and the slope of the spectrum curve in normal perfusion areas were(14.49±5.20)mg/mL and 1.29±0.39.The iodine content and the slope of the spectrum curve were(-12.59±3.32)mg/mL and-0.98±0.35 in the abnormal area.The difference between the two was statistically significant(P<0.05).Conclusion:Gemstone CT is useful for assessing myocardial ischemia through the analysis of myocardial iodine content in the first pass while evaluating coronary artery stenosis.