负荷动态CT心肌灌注联合冠状动脉CT血管成像在冠心病心肌缺血诊断中的应用价值
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摘要
目的探讨负荷动态CT心肌灌注(CT-MPI)联合冠状动脉CT血管成像(CCTA)在冠心病心肌缺血诊断中的应用价值。方法选取我院2017年1～12月收治的40例冠心病心肌缺血患者作为研究对象,分别给于单纯CCTA及联合CT-MPI检查诊断,其中将CT-MPI结合CCTA作为观察组,单纯CCTA作为对照组,每组各20例。比较两组使用对比造影剂剂量及放射剂量、两组对斑块导致管腔狭窄比例及斑块长度以及两组诊断率。结果观察组对比造影剂剂量小于对照组,差异有统计学意义(P<0.05),放射剂量低于对照组,差异有统计学意义(P<0.05),观察组斑块导致管腔狭窄比例明显大于对照组,差异有统计学意义(P<0.05),斑块长度明显长于对照组,差异有统计学意义(P<0.05),观察组诊断率显著高于对照组,差异有统计学意义(P<0.05)。结论对冠心病心肌缺血者,实施CT-MPI结合CCTA,其所需造影剂计量小,放射剂量低,能有效明确冠状动脉狭窄与斑块病变情况,从而更好地提高临床诊断率。
Objective To investigate the application value of stress dynamic CT myocardial perfusion imaging(CT-MPI) combined with coronary CT angiography(CCTA) in diagnosing myocardial ischemia of coronary heart disease.Methods Forty patients with ischemic coronary artery diseases who were admitted to our hospital from January to December 2017 were selected as the study subjects. They were examined by CCTA alone and stress dynamic CT-MPI combined with CCTA. The former was classified into control group, and the latter was categorized into observation group, 20 cases in each group. The dosage of contrast agent and radiation dose, the proportion of luminal stenosis due to plaque, plaque length, and the diagnostic rates of the two groups were compared. Results Compared with the control group, the dosage of contrast agent in the observation group was lesser with a significant difference(P<0.05). The radiation dose was lower(P<0.05). The proportion of luminal stenosis due to plaque was higher than that in the control group with a significant difference(P<0.05). The plaque in the observation group was greatly longer than that of the control group(P<0.05). The diagnostic rate of the observation group was significantly higher than that of the control group with a statistical difference(P<0.05). Conclusion For patients with myocardial ischemia of coronary heart disease, application of stress dynamic CT-MPI and CCTA can effectively confirm the coronary artery stenosis and plaque lesions in a small dosage of contrast agent, a low radiation dose, and greatly increase the clinical diagnosis rate.
Objective To investigate the application value of stress dynamic CT myocardial perfusion imaging(CT-MPI) combined with coronary CT angiography(CCTA) in diagnosing myocardial ischemia of coronary heart disease.Methods Forty patients with ischemic coronary artery diseases who were admitted to our hospital from January to December 2017 were selected as the study subjects. They were examined by CCTA alone and stress dynamic CT-MPI combined with CCTA. The former was classified into control group, and the latter was categorized into observation group, 20 cases in each group. The dosage of contrast agent and radiation dose, the proportion of luminal stenosis due to plaque, plaque length, and the diagnostic rates of the two groups were compared. Results Compared with the control group, the dosage of contrast agent in the observation group was lesser with a significant difference(P<0.05). The radiation dose was lower(P<0.05). The proportion of luminal stenosis due to plaque was higher than that in the control group with a significant difference(P<0.05). The plaque in the observation group was greatly longer than that of the control group(P<0.05). The diagnostic rate of the observation group was significantly higher than that of the control group with a statistical difference(P<0.05). Conclusion For patients with myocardial ischemia of coronary heart disease, application of stress dynamic CT-MPI and CCTA can effectively confirm the coronary artery stenosis and plaque lesions in a small dosage of contrast agent, a low radiation dose, and greatly increase the clinical diagnosis rate.
引文
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[13]赵雪梅,李家俊,刘亚欣,等.多层螺旋CT血管造影在评价冠状动脉粥样硬化性心脏病患者心肌缺血程度中的价值[J].中国临床保健杂志,2017,20(6):693-696.
[14]黄海峡,陈宏伟,方向明.单纯性心肌桥-壁冠状动脉的双源CT表现与心肌缺血的相关性研究[J].海南医学,2015,26(10):1447-1450.
[15]冷利华,黄文胜,汪念东,等.无症状心肌缺血患者动态心电图与冠状动脉CT血管造影的对比分析[J].心肺血管病杂志,2013,32(3):277-279.
[16]李建龙,张虹,张变花,等.冠状动脉CT血管成像对冠心病等危症患者诊断心肌缺血的价值[J].心脏杂志,2016,28(5):568-572.
[17]郑波,张新毅,阴祖栋.多排螺旋CT心肌灌注诊断冠心病缺血心肌的应用价值[J].中国辐射卫生,2015,24(3):303-305.
[18]刘建花,亓俊杰.冠状动脉CT血管成像联合动态心电图在诊断冠心病心肌缺血中的应用[J].中国CT和MRI杂志,2017,15(9):61-63.
[2]王洁,陈宏伟,方向明,等.负荷动态CT心肌灌注成像对心肌缺血的诊断价值[J].临床放射学杂志,2015,34(1):41-45.
[3]董小波,李莹,张仲慧,等.CTCA结合CT首过心肌灌注成像诊断无症状性心肌缺血的价值探讨[J].医学影像学杂志,2017,27(4):635-639.
[4]董小波,王颖,于秀艳,等.动态心电图和CT首过心肌灌注成像在冠心病心肌缺血诊断中的对比分析[J].中国医药导报,2017,14(7):110-113.
[5]王洁,陈宏伟,方向明,等.负荷动态CT心肌灌注对检测心肌缺血及与其责任血管关系的探讨[J].南京医科大学学报(自然科学版),2014,34(9):1255-1259.
[6]覃钊凡,徐建.256层螺旋CT冠状动脉成像联合心电图评估心肌桥与心肌缺血的关系[J].心电与循环,2017,36(3):175-178.
[7]汪洋,徐国厚,江泓,等.多排螺旋CT冠状动脉成像评价心肌桥与心肌缺血的相关性研究[J].江苏医药,2016,42(14):1612-1614.
[8]师博.64排螺旋CT联合心肌灌注成像技术在冠状动脉狭窄患者心肌缺血的临床诊断特异度和灵敏度研究[J].检验医学与临床,2017,14(12):1833-1835.
[9]高宙,胡疏,王志坚,等.可视化发射CT评价针刺内关、心俞治疗冠心病心肌缺血的临床效应[J].中国中西医结合杂志,2013,33(9):1196-1198.
[10]李志铭,谭理连,全显跃,等.多排螺旋CT心肌灌注在诊断冠心病缺血心肌中的应用[J].广东医学,2013,34(2):221-224.
[11]邵静,李宁.同步12导联动态心电图和64排128层CT评价心肌缺血和冠状动脉狭窄的相关性研究[J].中国中西医结合影像学杂志,2016,14(2):163-165.
[12]Tanabe Y,Kido T,Uetani T,等.动态CT灌注成像识别心肌缺血与梗死,与心脏MR及SPECT进行比较[J].国际医学放射学杂志,2017,40(1):100.
[13]赵雪梅,李家俊,刘亚欣,等.多层螺旋CT血管造影在评价冠状动脉粥样硬化性心脏病患者心肌缺血程度中的价值[J].中国临床保健杂志,2017,20(6):693-696.
[14]黄海峡,陈宏伟,方向明.单纯性心肌桥-壁冠状动脉的双源CT表现与心肌缺血的相关性研究[J].海南医学,2015,26(10):1447-1450.
[15]冷利华,黄文胜,汪念东,等.无症状心肌缺血患者动态心电图与冠状动脉CT血管造影的对比分析[J].心肺血管病杂志,2013,32(3):277-279.
[16]李建龙,张虹,张变花,等.冠状动脉CT血管成像对冠心病等危症患者诊断心肌缺血的价值[J].心脏杂志,2016,28(5):568-572.
[17]郑波,张新毅,阴祖栋.多排螺旋CT心肌灌注诊断冠心病缺血心肌的应用价值[J].中国辐射卫生,2015,24(3):303-305.
[18]刘建花,亓俊杰.冠状动脉CT血管成像联合动态心电图在诊断冠心病心肌缺血中的应用[J].中国CT和MRI杂志,2017,15(9):61-63.