邓子龙,赵敏,邓豪余,李新辉.核素心肌灌注的定量及异质性分析对病毒性心肌炎的诊断价值[J].中国医学影像技术,2019,35(11):1652~1656
核素心肌灌注的定量及异质性分析对病毒性心肌炎的诊断价值
Value of quantitative and heterogeneous analysis of radionuclide myocardial perfusion in diagnosis of viral myocarditis
投稿时间:2019-03-11  修订日期:2019-08-20
DOI:10.13929/j.1003-3289.201903063
中文关键词:  心肌炎  心肌  放射性核素显像  异质性
英文关键词:myocarditis  myocardium  radionuclide imaging  heterogeneity
基金项目:
作者单位E-mail
邓子龙 中南大学湘雅医院核医学科, 湖南 长沙 410008  
赵敏 中南大学湘雅医院核医学科, 湖南 长沙 410008 mzhao1981@csu.edu.cn 
邓豪余 中南大学湘雅医院核医学科, 湖南 长沙 410008  
李新辉 中南大学湘雅医院核医学科, 湖南 长沙 410008  
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中文摘要:
      目的 探讨核素心肌灌注的定量及异质性分析诊断病毒性心肌炎(VMC)的价值。方法 回顾性分析接受99mTc-MIBI心肌灌注显像的疑似VMC患者37例,其中18例临床诊断为VMC(VMC组),其余19例排除VMC的患者为非VMC组。使用QPS软件获得静息灌注总积分(SRS)及总灌注缺损值(TPD),计算靶心图放射性计数异质性参数节段靶心图变异系数(CVs)和室壁靶心图变异系数(CVw),比较2组心肌灌注各参数的差异。应用ROC曲线评价各参数对VMC的诊断效能。结果 VMC组心肌灌注以左心室前壁和下壁降低最显著(P均<0.05);VMC组TPD、CVs较非VMC组均明显增高(P均<0.05);CVs对VMC炎诊断效能最优(AUC=0.83,P<0.01),当CVs阈值为10.5%时,其灵敏度为94.4%,特异度为73.7%。结论 心肌灌注异质性分析有助于VMC的诊断和鉴别诊断。
英文摘要:
      Objective To evaluate the value of quantitative and heterogeneous analysis of radionuclide myocardial perfusion in diagnosis of viral myocarditis (VMC). Methods 99mTc-MIBI myocardial perfusion imaging data of 37 patients suspected with VMC were analyzed retrospectively. Eighteen patients were clinical diagnosed as VMC (VMC group) and 19 patients excluded VMC were served as non-VMC group. Summed rest score (SRS) and the total perfusion deficit (TPD) were obtained by using QPS software. Heterogeneity parameters of radioactive count (segmental coefficient of variation and ventricular wall coefficient of variation) were also calculated. Perfusion parameters were compared between the two groups, and the diagnostic value on discrimination of VMC patients was evaluated by ROC analysis. Results Compared with non-VMC group, myocardial perfusion in anterior and inferior walls decreased significantly in VMC group (all P<0.05); TPD and CVs were significantly higher in VMC group (P<0.05). Efficiency of CVs in diagnosis of VMC was best (AUC=0.83, P<0.01). When the threshold of CVs was 10.5%, the diagnostic sensitivity was 94.4% and the specificity was 73.7%. Conclusion Heterogeneous analysis of myocardial perfusion is helpful for differential diagnosis of VMC.
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