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目的探讨利用电子束CT(EBCT)心肌灌注色彩编码技术分析心肌缺血性改变的影像学意义及临床价值。方法34例临床诊断心肌缺血患者进行了EBCT长轴或短轴多层电影和血流检查,经后处理得到左室心肌色彩编码参量图像及相关参数。34例中,心电图诊断心肌缺血28例,超声心动图诊断心肌缺血31例,核素心肌显像检查报告34例61个节段心肌缺血。结果EBCT检查报告34例54个节段心肌缺血,前壁18个节段、前间壁4个节段、侧壁15个节段、下后壁9个节段、心尖8个节段。EBCT报告心肌梗死的6例,核素心肌显像检查均得到同样的诊断。结论心肌灌注色彩编码参量图可客观反映心肌的缺血性改变,与核素心肌显像检查有良好的一致相关性,且直观效果强;同时,能为EBCT冠状动脉造影诊断冠状动脉狭窄提供佐证信息,提高其诊断准确性。
Objective To investigate the imaging significance and clinical value of myocardial perfusion color-coded electron beam computed tomography (EBCT) in the analysis of myocardial ischemic changes. Methods Thirty-four patients with clinical diagnosis of myocardial ischemia underwent long-axis or short-axis multi-layer EBCT screening and blood flow examination. Color coded parameters and parameters of left ventricular myocardium were obtained by post-treatment. Among the 34 cases, ECG was used to diagnose myocardial ischemia in 28 cases, echocardiography to diagnose myocardial ischemia in 31 cases, radionuclide myocardial imaging examination in 34 cases with 61 segments of myocardial ischemia. Results EBCT examination reported 34 cases of 54 segments of myocardial ischemia, 18 anterior wall segments, anterior wall 4 segments, 15 lateral segments, 9 posterior inferior segments, apical 8 segments. EBCT reported 6 cases of myocardial infarction, radionuclide myocardial imaging examination were the same diagnosis. Conclusion The myocardial perfusion color coded parametric map can objectively reflect the ischemic changes of myocardium and has a good consistent correlation with radionuclide myocardial imaging examination, and has a strong visual effect; at the same time, it can provide evidence for the diagnosis of coronary artery stenosis by EBCT coronary angiography Information, improve their diagnostic accuracy.