CAJ | 학술논문

目的：通过对心肌梗死患者行双源CT首过及延迟增强双能量扫描，与99mTc-MIBI心肌显像结果进行对比研究，探讨双源CT首过及延迟心肌灌注成像在识别及定位存活心肌的诊断价值。方法28例心肌梗死患者接受双源首过及延迟(5min)心肌灌注扫描及99mTc-MIBI心肌灌注显影检查，观察双源CT心肌灌注碘图评价心肌灌注缺损，将双源CT首过及延迟扫描心肌灌注缺损与99mTc-MIBI的相应节段进行对照。结果28例受检者，共476个心肌节段，双源CT首过扫描心肌灌注共有371节段灌注减低及缺损，其中延迟扫描共156个节段表现为低灌注，215个节段表现为相对高灌注(延迟强化)；99mTc-MIBI心肌灌注显影结果共有237心肌灌注减低及缺损；17个节段中，共13节段两者结果一致性好(Kappa值＞0.75)，其余4节段(第2、3、8、9节段)一致性一般(0.40＜Kappa值＜0.75)；第8节段敏感度最高为(100%)，第12节段特异度为最高为(100%)，第12节段准确度最高为(92.85%)。结论双源CT首过及延迟心肌灌注成像评价心肌活性与99mTc-MIBI心肌灌注显影对比结果一致性良好，可较为准确地定位心肌梗死，并对心肌活性作出评估。
목적：통과대심기경사환자행쌍원CT수과급연지증강쌍능량소묘，여99mTc-MIBI심기현상결과진행대비연구，탐토쌍원CT수과급연지심기관주성상재식별급정위존활심기적진단개치。방법28례심기경사환자접수쌍원수과급연지(5min)심기관주소묘급99mTc-MIBI심기관주현영검사，관찰쌍원CT심기관주전도평개심기관주결손，장쌍원CT수과급연지소묘심기관주결손여99mTc-MIBI적상응절단진행대조。결과28례수검자，공476개심기절단，쌍원CT수과소묘심기관주공유371절단관주감저급결손，기중연지소묘공156개절단표현위저관주，215개절단표현위상대고관주(연지강화)；99mTc-MIBI심기관주현영결과공유237심기관주감저급결손；17개절단중，공13절단량자결과일치성호(Kappa치＞0.75)，기여4절단(제2、3、8、9절단)일치성일반(0.40＜Kappa치＜0.75)；제8절단민감도최고위(100%)，제12절단특이도위최고위(100%)，제12절단준학도최고위(92.85%)。결론쌍원CT수과급연지심기관주성상평개심기활성여99mTc-MIBI심기관주현영대비결과일치성량호，가교위준학지정위심기경사，병대심기활성작출평고。
Objective To evaluate the feasibility and diagnostic accuracy of first-pass and delayed enhancement of dual-energy computed tomography(DECT) in myocardial perfusion imaging for detecting myocardial viability compared with99mTc-MIBI myocardial perfusion imaging.Methods Twenty-eight patients with coronary artery disease were detected by first-pass and delayed enhancement (5min) DECT and99mTc-MIBI PET respectively. A color-coded iodine map was used to evaluate the myocardial perfusion defects. Myocardial perfusion defects according to the first-pass and delayed enhancement were compared with99mTc-MIBI myocardial perfusion imaging on a segmental basis.Results A total of 476 myocardial segments of 28 patients were analyzed. 371 segments showed perfusion decrease or defects on first-pass DECT, while 156 segments low perfusion and 215 segments relatively high perfusion on delayed enhancement DECT. 237 segments perfusion decrease or defects showed on9mTc-MIBI myocardial perfusion imaging. Analysis is the assessment of myocardial viability revealed better agreement among 13 myocardial segments(kappa=1), good agreement among the left 4(2/3/8/9) myocardial segments(0.40 <kappa<0.75).The 8th segments had the highest sensitivity(100%), the 12th segments had the highest specificity(100%), and the 12th segments had the highest accuracy(92.85%).Conclusion There is high agreement between first-pass and delayed enhancement of dual-energy computed tomography(DECT) and 9mTc-MIBI myocardial perfusion imaging for detecting myocardial viability, which is a promising method to location Myocardial infarction, and evaluate myocardial viability.