SPECT/CT融合显像评估冠心病心肌血流异常与冠脉狭窄的关系分析

目的采用核素心肌灌注显像与冠状动脉计算机断层摄影(SPECT/CT)融合显像评估冠心病心肌血流异常与冠脉狭窄的关系。方法选择84例疑似冠心病并接受SPECT/CT显像的患者纳入研究,根据核素心肌灌注显像(MPI)计算心肌各节段负荷总积分(SSS)、静息总积分(SRS)、灌注积分差(SDS),并根据SSS分值分为轻度、中度、重度异常组;根据CT冠状动脉成像(CTCA)图像统计冠脉狭窄程度,分析心肌灌注异常区域SSS、SDS及冠脉狭窄程度的相关性。结果轻度异常组25例,中度异常组40例,重度异常组19例;MPI共检出血流灌注异常区96个,其中轻、中、重度异常患者灌注异常区分别为25、45及26个;CTCA示轻、中、重度分别有23、45及26个异常灌注区冠脉存在狭窄;心肌血流灌注SSS、SDS与冠脉狭窄程度均呈正相关(r=0.622、0.451,P<0.05);其中轻、中、重度异常组SSS与冠脉狭窄程度呈正相关(r=0.417、0.627及0.546,P<0.05);轻、中、重度异常组SDS与冠脉狭窄程度也呈正相关(r=0.358、0.487及0.519,P<0.05)。结论冠心病患者心肌血流异常与冠脉狭窄呈正相关,其中,中、重度灌注异常患者心肌灌注状态与冠脉狭窄程度相关性更强。

The Relationship Between Abnormal Myocardial Blood Flow and Coronary Artery Stenosis in Coronary Heart Disease Evaluated by the Fusion Imaging of SPECT/CT

Objective To evaluate the relationship between abnormal myocardial blood flow and coronary artery stenosis in coronary heart disease by the fusion imaging of nuclide myocardial perfusion imaging and coronary computed tomography(SPECT/CT).Methods Eighty-four patients with suspected coronary heart disease who underwent SPECT/CT imaging were enrolled in the study.The summed stress score(SSS),summed rest score(SRS),and summed difference score(SDS)of each segment of the myocardium were calculated according to the myocardial perfusion imaging(MPI).According to the SSS,patients were divided into mildly,moderately,and severely abnormal groups.The degree of coronary artery stenosis was statistically analyzed according to images of CT coronary angiography(CTCA).The correlation of SSS and SDS in abnormal myocardial perfusion zone with the degree of coronary artery stenosis was analyzed.Results There were 25 cases,40 cases,and 19 cases in the mildly abnormal group,moderately abnormal group,and severely abnormal group.There were 96 abnormal blood perfusion zones detected by MPI,including 25 mild,45 moderate,and 26 severe abnormal perfusion zones.CTCA showed coronary stenosis in 23,45 and 26 abnormal perfusion zones in patients with mild,moderate,and severe abnormalities,respectively.SSS and SDS of myocardial blood perfusion were positively correlated with the degree of coronary stenosis(r=0.622,0.451,P<0.05).SSS was positively correlated with the degree of coronary stenosis in the mildly,moderately,and severely abnormal groups(r=0.417,0.627,0.546,P<0.05).SDS was also positively correlated with the degree of coronary stenosis in the mildly,moderately,and severely abnormal groups(r=0.358,0.487,0.519,P<0.05).Conclusion Abnormal myocardial blood flow is positively correlated with coronary artery stenosis in patients with coronary heart disease.The correlation between myoca rdial perfusion status and the degree of coronary artery stenosis is stronger in patients with moderate or severe perfusion abnormalities.