| 代旭,邓建宏,余蒙蒙,于丽华,潘静薇,张佳胤.低剂量动态心肌灌注定量的心肌血流量与ST段抬高型心梗患者高敏肌钙蛋白峰值水平及左心功能相关性的研究[J].中国医学影像技术,2020,36(2): |
| 低剂量动态心肌灌注定量的心肌血流量与ST段抬高型心梗患者高敏肌钙蛋白峰值水平及左心功能相关性的研究 |
| Low-Dose Dynamic CT Myocardial Perfusion Imaging derived Myocardial Blood Flow Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction |
| 投稿时间：2019-05-21 修订日期：2020-02-18 |
| DOI： |
| 中文关键词: 冠状动脉疾病 急性心肌梗死 肌钙蛋白 心肌血流量 体层摄影术，Ｘ线计算机 |
| 英文关键词:Acute myocardial infarction Troponin Myocardial perfusion imaging Computed tomography Myocardial blood flow |
| 基金项目:上海市重中之重临床医学中心和重点学科建设计划 |
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| 中文摘要: |
| 目的 研究低剂量动态心肌灌注定量的心肌血流量与ST段抬高型心肌梗死患者（ST-segment elevated myocardial infarction, STEMI）患者高敏肌钙蛋白（High-sensitive cardiac troponin T, hs-TnT）峰值水平及左心室功能受损程度的相关性。方法 入组发病1周内成功行血管再通术STEMI患者35例，行动态负荷CT动态心肌血流灌注（Stress computed tomography myocardial perfusion imaging, CT-MPI）检查，分别计算相关血流动力学参数；同时收集患者hs-TnT数值及左心室射血分数（left ventricular ejection fraction, LVEF）。最终对25例患者相关血流动力学参数与hs-TnT水平及LVEF进行相关性分析。结果 动态CT-MPI平均辐射剂量为236±80.29mGy·cm；梗死心肌区域MBF（30.8 ± 14.65 mL/min/100 mL比72.8±10.7mL/min/100 mL, p< 0.001）与MBV（1.7±1.4mL/100 mL比4.1±2.0mL/100 mL p=0.024）数值显著低于参考区域；MBF与hs-TnT峰值（r= -0.605，p=0.001）及LVEF数值（r=0.463，p=0.02）显著相关;然而其他血流动力学参数与hs-TnT峰值及LVEF数值并未存在相关性。结论 动态CT-MPI定量计算的MBF值与hs-TnT峰值呈显著负相关；MBF值显著减低的患者左心室功能亦出现降低。 |
| 英文摘要: |
| Objective: To investigate the association of Low-Dose dynamic computed tomography (CT) myocardial perfusion imaging (MPI) derived myocardial blood flow (MBF) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods: Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-five patients were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission. Results: The mean radiation dose for dynamic CT-MPI was 236.00±80.29mGy·cm. Infarcted territories had significantly lower MBF (30.8 ± 14.65 mL/min/100 mL versus 72.8±10.7mL/min/100 mL, p< 0.001) and myocardial blood volume (MBV) (1.7±1.4mL/100 mL versus 4.1±2.0mL/100 mL p=0.024) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r= -0.605，p=0.001); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r=0.463，p=0.02). Conclusion: MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function. |
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