CT心肌灌注成像、ECV在OMI诊断中价值及与心肌损伤的关系

doi:10.7517/issn.1674-0475.210511

影像科学与光化学 ›› 2021, Vol. 39 ›› Issue (6): 911-915.DOI: 10.7517/issn.1674-0475.210511

CT心肌灌注成像、ECV在OMI诊断中价值及与心肌损伤的关系

刘烁, 周豪, 张梦琪, 帕丽旦·尼亚孜

新疆维吾尔自治区人民医院放射影像中心, 新疆乌鲁木齐 830000

收稿日期:2021-05-19 出版日期:2021-11-15 发布日期:2021-11-11
通讯作者: 帕丽旦·尼亚孜
基金资助:
新疆维吾尔自治区人民医院院内项目（20190318）

Diagnostic Value of CT Myocardial Perfusion Imaging and ECV in OMI and Their Relationship with Myocardial Injury

LIU Shuo, ZHOU Hao, ZHANG Mengqi, Palidan Nyaz

Radiology Center of Xinjiang Uiger Municipal Pople's Hospital, Urumqi 830000, Xinjiang, P. R. China

Received:2021-05-19 Online:2021-11-15 Published:2021-11-11

摘要/Abstract

摘要： 本研究探讨CT心肌灌注成像（CT-MPI）、细胞外容积（ECV）在陈旧性心肌梗死（OMI）诊断中的价值及与心肌损伤的相关性。选取82例OMI患者作为观察组，另选取同期健康者30例作为对照组，均行CT-MPI检查，对比两组CT-MPI参数、ECV，分析OMI发病影响因素及CT-MPI参数、ECV与心肌损伤指标的关系。结果显示，观察组cTnI、cTnT水平及ECV高于对照组，心肌血容量（MBV）、心肌血流量（MBF）低于对照组，且上述指标均为OMI发病影响因素（P<0.05）；OMI患者MBF、MBV与cTnI、cTnT水平呈负相关，ECV与cTnI、cTnT水平呈正相关（P<0.05）；MBF、MBV、ECV联合诊断OMI的ROC曲线下面积为0.950。CT-MPI参数MBF、MBV及ECV与OMI患者心肌损伤有关，CT-MPI参数、ECV检测可有效诊断OMI，利于临床诊治。

关键词: CT心肌灌注成像, 心肌血容量, 心肌血流量, 陈旧性心肌梗死, 肌钙蛋白I, 肌钙蛋白T

Abstract: This study explored the value of CT myocardial perfusion imaging (CT-MPI) and extracellular volume (ECV) in the diagnosis of old myocardial infarction (OMI) and their correlation with myocardial injury. A total of 82 patients with OMI were selected as the observation group and 30 healthy subjects in the same period were selected as the control group. The CT-MPI parameters and ECV of the two groups were compared, the influencing factors of OMI and the relationship between CT-MPI parameters, ECV and myocardial injury indexes were analyzed, and the diagnostic value of CT-MPI parameters and ECV for OMI was evaluated. The levels of cTnI, cTnT and ECV in the observation group were higher than those in the control group, MBF and MBV were lower than those in the control group, and all indexes were the influencing factors of OMI (P<0.05); MBF and MBV were negatively correlated with cTnI and cTnT levels, while ECV was positively correlated with cTnI and cTnT levels (P<0.05). The maximum AUC of OMI diagnosed by MBF, MBV and ECV was 0.950. CT-MPI parameters MBF, MBV and ECV are related to myocardial injury in patients with OMI. The detection of CT-MPI parameters and ECV can effectively diagnose OMI and facilitate clinical diagnosis and treatment.

Key words: CT myocardial perfusion imaging, myocardial blood volume (MBV), myocardial blood flow (MBF), old myocardial infarction, troponin I, troponin T

刘烁, 周豪, 张梦琪, 帕丽旦·尼亚孜. CT心肌灌注成像、ECV在OMI诊断中价值及与心肌损伤的关系[J]. 影像科学与光化学, 2021, 39(6): 911-915.

LIU Shuo, ZHOU Hao, ZHANG Mengqi, Palidan Nyaz. Diagnostic Value of CT Myocardial Perfusion Imaging and ECV in OMI and Their Relationship with Myocardial Injury[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(6): 911-915.

参考文献

[1] Germain P, El Ghannudi S, Labani A, et al. A dual flip angle 3D bSSFP magnetization transfer-like method to differentiate between recent and old myocardial infarction[J]. Journal of Magnetic Resonance Imaging, 2018, 47(3):798-808.
[2] 景林德, 连新龙, 孙海霞. 超声心动图检测陈旧性心肌梗死合并室壁运动异常患者5年随访结果分析[J]. 西部医学, 2017, 29(12):1680-1682, 1687.
[3] 陈军红, 李东野, 韩曙光, 等. 小剂量多巴酚丁胺负荷下超声斑点追踪技术与磁共振延迟增强显像技术评价陈旧性心肌梗死存活性研究[J]. 中国循环杂志, 2017, 32(11):1066-1070.
[4] 代旭, 邓建宏, 余蒙蒙, 等. ST段抬高型心肌梗死患者低剂量动态心肌灌注定量心肌血流量与高敏肌钙蛋白峰值水平及左心室功能的相关性[J]. 中国医学影像技术, 2020, 36(2):184-189.
[5] 陈冰华, 安东敖蕾, 何杰, 等. 基于双层探测器光谱CT碘密度成像定量评估急性ST段抬高型心肌梗死细胞外容积分数[J]. 中华放射学杂志, 2020, 54(6):527-533.
[6] 安蓉, 刘黎明. cTnI、cTnT检测对急性心肌梗死诊断的应用价值分析[J]. 检验医学与临床, 2019, 16(8):1139-1141.
[7] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南[J]. 中华心血管病杂志, 2015, 43(5):380-393.
[8] Nakamura S, Kitagawa K, Goto Y, et al. Incremental prognostic value of myocardial blood flow quantified with stress dynamic computed tomography perfusion imaging[J]. JACC:Cardiovascular Imaging, 2019, 12(7):1379-1387.
[9] 于丽华, 顾耕, 代旭, 等. 基于第三代双源CT动态心肌灌注成像不同负荷后心率增量者的正常心肌血流量范围[J]. 中华放射学杂志, 2021, 55(2):123-129.
[10] Niccoli G, Scalone G, Lerman A, et al. Coronary microvascular obstruction in acute myocardial infarction[J]. European Heart Journal, 2016, 37(13):1024-1033.
[11] 马海彦, 王玉权, 谢光友, 等. 动态CT心肌灌注成像定量心肌血流量与ST段抬高心肌梗死患者肌钙蛋白水平及左心室功能受损的相关性[J]. 实用医学杂志, 2020, 36(10):1371-1375.
[12] 周振, 徐磊, 范占明. 基于心脏CT的细胞外容积量化在弥漫性心肌纤维化中的研究进展[J]. 心肺血管病杂志, 2018, 37(7):707-710.

CT心肌灌注成像、ECV在OMI诊断中价值及与心肌损伤的关系

Diagnostic Value of CT Myocardial Perfusion Imaging and ECV in OMI and Their Relationship with Myocardial Injury

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

编辑推荐

Metrics

本文评价

[1]	陈烨昕, 高慧, 孟晴晴. 多层螺旋CT、心脏超声联合血清DGCR8、cTnT在诊断患儿先天性心脏病中的应用[J]. 影像科学与光化学, 2022, 40(4): 937-941.
[2]	崔林, 王海霞, 王建松, 张杰, 王敏. 高剂量瑞芬太尼对冠心病无痛胃镜检查患者循环系统及cTnI、BNP的影响[J]. 影像科学与光化学, 2020, 38(3): 535-539.