SPECT/CT融合显像对冠心病心肌血流异常与冠脉狭窄的关系分析

目的应用SPECT/CT融合显像技术分析冠心病心肌血流异常与冠脉狭窄的关系。方法回顾性分析2017年6月~2019年1月我院收治的134例冠心病患者临床资料,所有患者均完成核素MPI及CTCA检查,完成图像重建及图像融合。根据MPI靶心图计算心肌负荷总积分(SSS),并根据SSS将患者分为轻度灌注异常组、中度灌注异常组、重度灌注异常组。结果134例患者(共有143个血流灌注异常区),其中轻度灌注异常组71例,有71个心肌灌注异常区;中度灌注异常组29例,33个心肌灌注异常区;重度灌注异常组34例,39个心肌血流灌注异常区。143个血流灌注异常区,冠脉正常16个,冠脉狭窄程度<25%、狭窄程度为25%~50%、狭窄程度为51%~74%、狭窄程度为75%~99%及完全闭塞的个数分别为19、23、44、38、3。Spearman相关分析显示,心肌血流异常区负荷积分、灌注积分差都和冠脉狭窄程度呈正关联(r=0.598、0.451,P<0.05)。各组分析:轻度灌注异常组、中度灌注异常组、重度灌注异常组心肌血流异常区负荷积分、灌注积分差与冠脉狭窄程度的相关系数分别为0.438和0.328、0.631和0.482、0.441和0.312。结论SPECT/CT融合显像对于功能相关性冠脉病变有重要诊断价值。冠心病心肌血流异常与冠脉狭窄关系密切,尤以中度灌注异常组显著。

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

Objective To analyze the relationship between myocardial blood flow abnormalities and coronary artery stenosis in coronary heart disease by SPECT/CT fusion imaging. Methods The clinical data of 134 patients with coronary heart disease who were admitted to the hospital from June 2017 to January 2019 were retrospectively analyzed. All patients underwent nuclide MPI and CTCA examinations and completed image reconstruction and image fusion. The summed stress score(SSS) was calculated according to the MPI bull-eye plot, and the patients were divided into mild perfusion abnormality group, moderate perfusion abnormality group and severe perfusion abnormality group according to SSS. Results The 134 patients(a total of 143 abnormal blood perfusion areas) were divided into 71 patients(mild perfusion abnormality group, 71 abnormal perfusion areas), 29 patients(moderate perfusion abnormality group, 33 abnormal perfusion areas) and 34 patients(severe perfusion abnormality group, 39 abnormal perfusion areas). In 143 abnormal blood perfusion areas, 16 coronary arteries were normal. The numbers of coronary arteries with stenosis <25%, stenosis of 25%~50%, stenosis of 51%~74%, stenosis of 75%~99% and total occlusion were 19, 23, 44, 38 and 3, respectively. Spearman correlation analysis showed that the load integral and perfusion integral difference of abnormal myocardial blood flow areas were positively correlated with the degree of coronary artery stenosis(r=0.598, 0.451, P<0.05). The correlation coefficients of the load integral and perfusion integral difference of abnormal myocardial blood flow areas with the degree of coronary artery stenosis in mild perfusion abnormality group, moderate perfusion abnormality group and severe perfusion abnormality group were 0.438 and 0.328, 0.631 and 0.482, 0.441 and 0.312. Conclusion SPECT/CT fusion imaging is of great diagnostic value for function related coronary artery lesions. Myocardial blood flow abnormalities in coronary heart disease are closely related to coronary artery stenosis, especially in the moderate perfusion abnormalities.