负荷动态CT心肌灌注成像联合动态心电图QTc间期在冠心病心肌缺血诊断中的应用

例冠心病患者均行负荷动态CT心肌灌注成像(CT-MPI)、动态心电图检查,采用CT-MPI、动态心电图对冠心病心肌缺血进行定性分析。结果显示:与灌注正常组比较,灌注异常组MBF、MBV明显低,TTP明显长(P＜0.05)；在ST段严重压低时CAG阳性组QT、QTc间期较CAG阴性组明显长(P＜0.05)；以CAG检查结果为金标准,CT-MPI诊断冠心病心肌缺血的灵敏度为91.11%、特异度70.59%、准确度85.48%,动态心电图诊断冠心病心肌缺血的灵敏度为71.11%、特异度94.12%、准确度77.43%；CT-MPI联合动态心电图诊断冠心病心肌缺血的准确率较CT-MPI检查、动态心电图诊断的明显大。CT-MPI联合动态心电图QTc间期可提高冠心病心肌缺血诊断的准确率,有一定临床推广应用优势。

Application of stress dynamic CT myocardial perfusion imaging combined with dynamic electrocardiogram QTc in diagnosis of myocardial ischemia with coronary heart disease

patients with coronary heart disease underwent CT-MPI and dynamic electrocardiography. CT-MPI and dynamic electrocardiogram were performed to qualitatively analyze myocardial ischemia with coronary heart disease. The results showed that compared with normal perfusion group, MBF and MBV were significantly lower in abnormal perfusion group, while TTP was significantly longer (P<0.05). QT and QTc in positive CAG group were significantly longer than those in negative CAG group when ST segment was severely depressed (P<0.05). Taking CAG test results as golden standard, sensitivity, specificity and accuracy of CT-MPI in diagnosis of myocardial ischemia with coronary heart disease were 91.11%, 70.59% and 85.48%, respectively. The above indexes of dynamic electrocardiogram were 71.11%, 94.12% and 77.43%, respectively. The accuracy of CT-MPI combined with dynamic electrocardiogram for diagnosis of myocardial ischemia with coronary heart disease was significantly larger than that of CT-MPI and dynamic electrocardiogram alone. CT-MPI combined with dynamic electrocardiogram QTc can improve diagnostic accuracy for myocardial ischemia with coronary heart disease, with certain advantages in clinical application.