中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
8期
672-675
,共4页
冠状动脉疾病%体层摄影术,螺旋计算机%心肌再灌注
冠狀動脈疾病%體層攝影術,螺鏇計算機%心肌再灌註
관상동맥질병%체층섭영술,라선계산궤%심기재관주
Coronary disease%Tomography,spiral computed%Myocardial reperfusion
目的 分析64层螺旋CT冠状动脉CT血管成像(CrA)检查中,心肌灌注与左冠状动脉狭窄程度及陈旧性心肌梗死心肌活性的相关性.方法 分析223例行64层CT冠状动脉CTA检查患者增强扫描图像,依照左冠状动脉狭窄程度分为正常(91例)、轻度(72例)、中度(36例)及重度狭窄组(24例),重度狭窄组中11例为陈旧性心肌梗死,分别测量每组患者心尖部、室间隔前部及左心室侧壁心肌密度,并进行方差分析；另外在CTA增强及延迟扫描图像中测量陈旧性心肌梗死患者梗死区及正常区域心肌密度,并进行方差分析.结果 (1)左冠状动脉重度狭窄组心尖部、室间隔前部及左心室侧壁的心肌密度分别为(55.8±21.4)、(87.8±3.3)和(86.8±7.9)HU,均低于正常组的相应部位[分别为(75.3±7.5)、(98.2±5.2)、(95.6±11.6)HU,P均＜0.05].轻度狭窄组和中度狭窄组与正常组这3个部位心肌密度的差异无统计学意义.(2)陈旧性心肌梗死患者正常区域延迟后心肌密度明显低于增强时[(70.9±8.3)HU比(98.7±7.3)HU,P＜0.01],梗死区延迟后心肌密度高于增强时[(42.5 ±15.7)HU比(17.8 ±4.1)HU,P＜0.01].结论 应用64层CT冠状动脉CTA测量心肌密度可初步判断左冠状动脉狭窄的严重程度,心肌延迟强化可初步判定陈旧性心肌梗死的心肌活性.
目的 分析64層螺鏇CT冠狀動脈CT血管成像(CrA)檢查中,心肌灌註與左冠狀動脈狹窄程度及陳舊性心肌梗死心肌活性的相關性.方法 分析223例行64層CT冠狀動脈CTA檢查患者增彊掃描圖像,依照左冠狀動脈狹窄程度分為正常(91例)、輕度(72例)、中度(36例)及重度狹窄組(24例),重度狹窄組中11例為陳舊性心肌梗死,分彆測量每組患者心尖部、室間隔前部及左心室側壁心肌密度,併進行方差分析；另外在CTA增彊及延遲掃描圖像中測量陳舊性心肌梗死患者梗死區及正常區域心肌密度,併進行方差分析.結果 (1)左冠狀動脈重度狹窄組心尖部、室間隔前部及左心室側壁的心肌密度分彆為(55.8±21.4)、(87.8±3.3)和(86.8±7.9)HU,均低于正常組的相應部位[分彆為(75.3±7.5)、(98.2±5.2)、(95.6±11.6)HU,P均＜0.05].輕度狹窄組和中度狹窄組與正常組這3箇部位心肌密度的差異無統計學意義.(2)陳舊性心肌梗死患者正常區域延遲後心肌密度明顯低于增彊時[(70.9±8.3)HU比(98.7±7.3)HU,P＜0.01],梗死區延遲後心肌密度高于增彊時[(42.5 ±15.7)HU比(17.8 ±4.1)HU,P＜0.01].結論 應用64層CT冠狀動脈CTA測量心肌密度可初步判斷左冠狀動脈狹窄的嚴重程度,心肌延遲彊化可初步判定陳舊性心肌梗死的心肌活性.
목적 분석64층라선CT관상동맥CT혈관성상(CrA)검사중,심기관주여좌관상동맥협착정도급진구성심기경사심기활성적상관성.방법 분석223례행64층CT관상동맥CTA검사환자증강소묘도상,의조좌관상동맥협착정도분위정상(91례)、경도(72례)、중도(36례)급중도협착조(24례),중도협착조중11례위진구성심기경사,분별측량매조환자심첨부、실간격전부급좌심실측벽심기밀도,병진행방차분석；령외재CTA증강급연지소묘도상중측량진구성심기경사환자경사구급정상구역심기밀도,병진행방차분석.결과 (1)좌관상동맥중도협착조심첨부、실간격전부급좌심실측벽적심기밀도분별위(55.8±21.4)、(87.8±3.3)화(86.8±7.9)HU,균저우정상조적상응부위[분별위(75.3±7.5)、(98.2±5.2)、(95.6±11.6)HU,P균＜0.05].경도협착조화중도협착조여정상조저3개부위심기밀도적차이무통계학의의.(2)진구성심기경사환자정상구역연지후심기밀도명현저우증강시[(70.9±8.3)HU비(98.7±7.3)HU,P＜0.01],경사구연지후심기밀도고우증강시[(42.5 ±15.7)HU비(17.8 ±4.1)HU,P＜0.01].결론 응용64층CT관상동맥CTA측량심기밀도가초보판단좌관상동맥협착적엄중정도,심기연지강화가초보판정진구성심기경사적심기활성.
Objective To evaluate the association between left coronary artery stenosis degree and myocardial perfusion by 64 multi-slice CT.Methods A total of 223 patients underwent 64 multi-slice CT coronary artery images (CTA) were included and divided into normal group( 91 cases),mild stenosis group ( 72 cases),moderate stenosis group ( 36 cases ) and severe stenosis group ( 24 cases ).Myocardial density was measured at apical,septal and lateral segments.Myocardial density in infarcted segments was compared to non-infarct segments in 11 patients with old myocardial infarction (all from severe stenosis group ).Results Myocardial density was significantly lower at apical segments [ ( 55.8 ± 21.4 ) HU vs. ( 75.3 ±7.5) HU ],at septal segment [ (87.8 ± 3.3 ) HU vs.( 98.2 ± 5.2) HU ] and at lateral segment [ ( 86.8 ±7.9) HU vs.(95.6 ± 11.6) HU ] in severe stenosis group than in normal group ( all P ＜ 0.05).Myocardial density of patients with old myocardial infarction was significantly reduced in non-infarct segment [ (70.9 ±8.3)HUvs.(98.7 ±7.3)HU,P ＜0.01] and increased in infarct segment [(42.5 ± 15.7)HU vs.( 17.8 ± 4.1 ) HU,P ＜0.01 ] post contrast enhancement.Conclusion CTA could be used to evaluate the severity of the left coronary artery stenosis based on myocardial density measurement. Myocardial delayed enhancement derived from CTA could be used to identify infarct segements.
