能谱CT在缺血性心脏病患者心功能评估中的临床应用研究

目的:研究评价能谱CT成像的功能参数在缺血性心脏病患者心功能评估方面的临床应用价值。方法:收集我院40例行心功能检查的缺血性心脏病病人，患者均行宝石能谱CT高分辨率扫描模式的回顾性心电门控冠脉CTA扫描和延迟1 min双能量能谱成像（GSI）模式扫描。在一周内行MRI心脏电影成像。在GSI浏览器能谱分析软件上获得能谱CT 40~140 keV单光子能量图像及碘基物质密度图像，分别测得缺血心肌、正常心肌能谱曲线和碘浓度（IC）。心功能软件自动计算出左室舒张末期容积、收缩末期容积和射血分数。将所得结果和MRI评估结果做对照分析。结果:能谱CT缺血心肌、正常心肌能谱曲线斜率（K值）之间存在显著差异，正常心肌能谱曲线斜率>缺血心肌能谱曲线斜率；缺血心肌与正常心肌之间碘浓度存在显著差异，缺血心肌碘浓度显著低于正常心肌碘浓度，能谱CT缺血心肌对应MRI电影图像均有相应节段室壁运动度减弱；能谱CT计算出的舒张末期容积、收缩末期容积和射血分数与MRI电影图像计算出的数值有较高的相关性和一致性。结论:能谱CT结合心功能分析软件能够定量评估缺血性心脏病患者的心肌供血情况以及心功能情况。 

Clinical Application of Dual Energy Spectral CT in Evaluating Cardiac Function in Patients with Ischemic Heart Disease

Objective: To study the clinical application value of spectral CT in evaluating cardiac function in patients with ischemic heart disease,so as to provide a novel and reliable imaging diagnostic system for cardiac function. Methods: 40 patients with ischemic heart disease were scanned with the high resolution density coronary CT angiography(HDCTA) and the gemstone spectral imaging(GSI) modes. In addition, all cases had the Cardiac MRI scan within a week. Obtained monochromatic images(40 ~ 140 ke V) and the iodine-based material-decomposition images from Spectral Analysis Software. The k value and the iodine concentration of the normal myocardial and ischemic myocardium were obtained respectively. Software automatically calculate the EDV, ESV, EF of left ventricular. The results were compared with MRI evaluation results. Results: The k value and the iodine concentration of normal myocardial were higher than the ischemic myocardium. Ischemic myocardium detected on Spectral CT showed the corresponding segment wall motion degree decreased in cine-MRI imaging. There were good correlation and consistency between the EDV, ESV, EF calculated by HDCTA and the results calculated by MRI. Conclusions: Dual Energy Spectral CT combined with cardiac function analysis software can quantitatively evaluate myocardial blood supply, effectively evaluate cardiac function in patients with ischemic heart disease.