心肌灌注显像联合冠状动脉钙化积分诊断冠心病的价值及最新进展

心肌灌注显像（MPI）在冠心病的诊断、危险度分层及预后评价中扮演着越来越重要的角色,冠状动脉钙化积分（CACS）可协助对冠心病患者进行进一步的危险度分层,但两者有各自的局限性和不足。将两者联合应用可以相互弥补不足,为临床提供更多的信息。行SPECT/CT心肌灌注显像时,需进行衰减矫正CT（CTAC）扫描,若采用心电门控的呼气末屏气螺旋CT扫描,则在用于MPI衰减矫正的同时又可用于CACS测定,实现一站式检查,在减少患者辐射剂量的同时又可为临床提供更多的信息。笔者综述了CACS、MPI及两者联合应用的临床价值,并对一站式采集MPI与CACS的最新进展进行了综述。

Clinical value and latest developments of coronary artery calcification scores and gated myocardial perfusion imaging in the diagnosis of coronary artery disease

Myocardial perfusion imaging(MPI) plays an increasingly important role in the diagnosis,risk stratification,and prognosis of coronary heart disease,and coronary artery calcification scoring (CACS) can refine the risk stratification and prognosis of coronary heart disease.However,both methods possess limitations and deficiencies.The combination of CACS and MPI compensates for these deficiencies and provides detailed information to the physician.SPECT/CT generates CT images for attenuation correction when collecting MPI.CACS scans acquired during normal expiration can also be used for attenuation correction.The use of these scans not only reduces the radiological dose but also provides detailed information to the physician.This review focuses on the clinical values of CACS,MPI,and their combination and presents the latest developments in obtaining MPI and CACS images in one scan.