CTCA联合CT首过心肌灌注成像检查在无症状性心肌缺血诊断中的应用效果

目的分析CT冠状动脉(CTCA)联合CT首过心肌灌注成像(CT first－pass MPI)检查在无症状性心肌缺血(SMI)诊断中的应用价值。 方法选取2016年4月至2017年12月胶州市人民医院收治的79例疑似SMI患者，均行核素心肌灌注成像(MPI)、CTCA检查、CT first－pass MPI检查，以MPI检查结果为准，统计CTCA检查、CT first－pass MPI检查、联合检查确诊SMI情况及诊断灵敏度、准确度、特异度。 结果79例SMI患者中：MPI检出48例SMI，31例无心肌缺血；CTCA检出50例SMI，29例无心肌缺血；CT first－pass MPI检出53例SMI，26例无心肌缺血；联合检查检出54例SMI，25例无心肌缺血；CTCA检查、CT first－pass MPI检查、联合检查灵敏度、准确度比较差异显著(P<0.05)；联合检查灵敏度95.83%、准确度87.34%高于CTCA检查72.92%、64.56%(P<0.05)。 结论CTCA与CT first－pass MPI联合应用诊断SMI，不仅可了解冠脉狭窄程度与位置，亦可观察心肌血流灌注情况，诊断价值较高。

Application of CTCA combined with CT first-pass myocardial perfusion imaging in the diagnosis of silent myocardial ischemia

ObjectiveTo observe the application value of CT coronary angiography (CTCA) combined with CT first-pass myocardial perfusion imaging (MRI) in the diagnosis of silent myocardial ischemia (SMI). MethodsSeventy-nine patients with suspected SMI admitted to Jiaozhou People's Hospital from April of 2016 to December of 2017 were examined by MPI, CTCA and CT first-pass MRI. Based on the results of MPI, were used to determine the diagnostic sensitivity, accuracy and specificity of CTCA, CT first-pass MPI and combined examination were counted. ResultsAmong 79 SMI patients, 48 SMI cases were diagnosed by MPI, 31 without myocardial ischemia; 50 SMI cases were diagnosed by CTCA, 29 without myocardial ischemia; 53 SMI cases were detected by CT first-pass MPI, 26 without myocardial ischemia; 54 SMI cases were detected by joint examination, 25 without myocardial ischemia. CTCA, CT first-MPI pass and combined examination had poor sensitivity and accuracy. The sensitivity and accuracy of combined examination were 95.83% and 87.34%, higher than those of CTCA examination (72.92% and 64.56%), and the differences were statistically significant(P<0.05). ConclusionThe combined application of CTCA and CT first-pass MPI can not only show the degree and location of coronary stenosis in the diagnosis of SMI, but also display the myocardial perfusion. The diagnostic value is high.