目的 对比腺苷负荷核素心肌灌注成像结果,探讨静息状态下CT心肌首过灌注成像检测心肌缺血的可行性与准确性。方法22例怀疑或诊断为冠心病的患者,在2周内完成CT冠状动脉造影(CTCA)和腺苷负荷/静息核素心肌灌注成像(MPS)检查。应用CTCA的原始数据进行cT心肌首过灌注成像分析,以腺苷负荷/静息MPS结果为参照,评价CT心肌首过灌注成像检测心肌缺血的准确性。结果以MPS结果作为参照,CT心肌首过灌注成像检测心肌缺血的敏感性为92%(12/13),特异性为78%(7/9),阳性预测值为86%(12/14),阴性预测值为88%(7/8),准确性为86%(19/22)。2种检查方法在检出率上差异无统计学意义(P〉0.05)。结论静息状态下CT心肌首过灌注成像评价心肌灌注的方法临床可行,且对检测心肌缺血有着较高的准确性。
Objective To assess the feasibility and accuracy of CT first-pass myocardial perfusion imaging (CT first-pass MPI ) at rest for diagnosis of myocardial ischemia. Results of adenosine-induced myocardial perfusion scintigraphy (MPS) were used as gold standard. Methods Twenty-two patients with suspected or diagnosed coronary artery disease (CAD) were included and CT coronary angiography (CTCA) and MPS were performed within 2 weeks. CT first-pass MPI detected myocardial ischemia results through analyzing the raw date of CTCA were compared with MPS results. Results The sensibility, specificity, positive predictive value ( PPV), negative predictive value (NPV) and accuracy of CT first-pass MPI at rest for detecting myocardial ischemia were 92% (12/13) , 78% (7/9) , 86% (12/14), 88% (7/8) and 86% (19/22), respectively. Conclusion CT first-pass MPI at rest could detect myocardial ischemia with an accuracy similar to that of MPS.