CAJ | 학술논문

_目的：探讨双源双能量 CT 进行心肌灌注成像的临床应用价值。方法：采用双源 CT 双能量心肌灌注成像方法对30例受检者进行扫描，对所有冠状动脉图像质量及心肌碘图灌注程度进行评分，并对冠状动脉狭窄程度进行分级，然后对冠状动脉狭窄程度与心肌碘图评分情况进行对照分析。结果：30例受检者冠状动脉 CTA 图像质量均满足诊断要求。30例受检者中有19例共计36支冠状动脉分支出现不同程度的狭窄或闭塞，其中轻度狭窄22支，中度狭窄6支，重度狭窄7支，次全闭塞1支。30例受检者心肌碘图均可进行碘分布情况评分。510个左室心肌节段中0分21个节段（4．1％），1分75个节段（14．7％），2分218个节段（42．7％），3分196个节段（38．4％）。轻度、中度、重度狭窄及闭塞对应2分以上心肌节段比例分别为85．6％、76．7％、93．0％及100．0％。冠状动脉狭窄程度与心肌灌注评分之间存在不一致。结论：双能量心肌灌注作为“一站式”完成冠状动脉及心肌灌注联合评价的技术具有一定应用潜力。目前校正双能量扫描所产生的各种伪影，提高心肌灌注评分与冠状动脉狭窄程度的一致性是促进该技术广泛应用于临床的关键。
_목적：탐토쌍원쌍능량 CT 진행심기관주성상적림상응용개치。방법：채용쌍원 CT 쌍능량심기관주성상방법대30례수검자진행소묘，대소유관상동맥도상질량급심기전도관주정도진행평분，병대관상동맥협착정도진행분급，연후대관상동맥협착정도여심기전도평분정황진행대조분석。결과：30례수검자관상동맥 CTA 도상질량균만족진단요구。30례수검자중유19례공계36지관상동맥분지출현불동정도적협착혹폐새，기중경도협착22지，중도협착6지，중도협착7지，차전폐새1지。30례수검자심기전도균가진행전분포정황평분。510개좌실심기절단중0분21개절단（4．1％），1분75개절단（14．7％），2분218개절단（42．7％），3분196개절단（38．4％）。경도、중도、중도협착급폐새대응2분이상심기절단비례분별위85．6％、76．7％、93．0％급100．0％。관상동맥협착정도여심기관주평분지간존재불일치。결론：쌍능량심기관주작위“일참식”완성관상동맥급심기관주연합평개적기술구유일정응용잠력。목전교정쌍능량소묘소산생적각충위영，제고심기관주평분여관상동맥협착정도적일치성시촉진해기술엄범응용우림상적관건。
To explore the clinical value of dual-source dual-energy CT in myocardial perfusion imaging. Methods:Myocardial perfusion imaging was performed in 30 subjects using second-generation dual-source CT.Two senior radiologists assessed the image quality of coronary arteries,perfusion distribution of iodine map of myocardium,and degree of coronary artery stenosis.Afterwards,the two physicians correlated the degree of coronary artery stenosis with the perfu-sion distribution of iodine map.Results:Coronary CTA image qualities of 30 subjects all met the needs of diagnosis.A total of 36 branches of coronary arteries in 19 cases in 30 subjects displayed different degrees of stenosis or occlusion.There were 22 branches with mild stenosis,6 branches with moderate stenosis,7 branches with severe stenosis,and 1 branch with sub-total block.Myocardial iodine maps from 30 cases of subjects could all be used for rating iodine distribution.In 510 seg-ments of myocardium of left ventricular,21 segments (4.1%)got 0 point,75 segments (14.7%)got 1 point,218 segments (42.7%)got 2 points,and 196 segments (38.4%)got 3 points.The ratios of the myocardium segments above 2 points, corresponding to mild,moderate,severe stenosis and occlusion,were 85.6%,76.7%,93.0% and 100.0% respectively.Con-clusion:Dual-energy myocardial perfusion as a"one-stop"technology for combined evaluation of coronary artery and myo-cardial perfusion examination,provides a certain application possibility.At present,correction of all kinds of artifacts in dual-energy scanning to improve the consistency between myocardial perfusion and coronary artery stenosis degree is the key to promoting this modality in clinical practice.