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目的:比较64排CT冠脉成像(CTCA)与PET-CT心肌灌注显像(MPI)对相关冠状动脉狭窄,及准确定位“罪犯”血管的价值。方法:回顾性分析内蒙古医科大学附属医院2009年3月到2014年12月,在四周内进行CTCA与MPI的临床确诊及可疑的冠心病(CAD)患者59例,由2名有经验影像与核医学医师进行图像及数据分析,按照冠状动脉节段性供血特点,分析冠状动脉供血区域和心肌节段对应关系,采用Spearman等级相关、Pearson相关和Kappa检验方法。结果:59例患者按照LAD、LCX、RCA三支冠状动脉支配心肌部位来统计,合计177支血管,冠脉血管0级58支;Ⅰ级24支;Ⅱ级33支;Ⅲ级40支;Ⅳ级22支。灌注0分63支;1分30支;2分45支;3分27支;4分12支。三支冠状动脉CTCA与MPI分别行相关性分析和吻合度分析,两者为正性相关,吻合率较高。LAD r=0.764,P=0.000;LCX r=0.593,P=0.000;RCA r=0.831,P=0.000。LAD k=0.666,P=0.000;LCX k=0.601,P=0.000;RCA k=0.589,P=0.000。结论:CTCA的解剖学信息和MPI生理学功能性信息相互结合,有效互补,两者结合能够准确定位CAD患者的“罪犯”血管,大大提高CAD诊断准确率,为临床治疗及预后判断提供有力依据。
Objective: To compare the value of 64-slice CT coronary angiography (CTCA) and PET-CT myocardial perfusion imaging (MPI) on related coronary stenosis and accurately locate the “culprit” vessels. Methods: A retrospective analysis of 59 cases of clinically diagnosed and suspicious coronary heart disease (CAD) patients with CTCA and MPI in the Affiliated Hospital of Inner Mongolia Medical University from March 2009 to December 2014 within four weeks, According to the characteristics of segmental coronary artery blood supply, the medical physicians analyzed the corresponding relationship between coronary artery blood supply and myocardial segments, using Spearman rank correlation, Pearson correlation and Kappa test. Results: Fifty-nine patients were classified according to the myocardial locations of the three branches of coronary artery including LAD, LCX and RCA. A total of 177 vessels and 58 coronary arteries were graded as grade 0, 24 as grade Ⅰ, 33 as grade Ⅱ, 40 as grade Ⅲ, Level 22 branch. Perfusion 0 points and 63; 1 point and 30 points; 2 points and 45 points; 3 points and 27 points; 4 points and 12 branches. Three coronary CTCA and MPI correlation analysis and goodness of fit analysis, both positive correlation, high coincidence rate. LAD r = 0.764, P = 0.000; LCX r = 0.593, P = 0.000; RCA r = 0.831, P = 0.000. LAD k = 0.666, P = 0.000; LCX k = 0.601, P = 0.000; RCA k = 0.589, P = 0.000. Conclusion: The anatomical information and MPI physiology functional information of CTCA are combined with each other and effectively complemented. The combination of the two can accurately locate the “criminals” blood vessels of CAD patients and greatly improve the diagnostic accuracy of CAD, which provides powerful clinical treatment and prognostic judgment in accordance with.