Han Ruijuan, Sun Kai, Lu Bin, Zhao Ruiping, Li Kuncheng, Yang Xinchun
Department of Cardiology, Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.
Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, P.R. China.
Exp Ther Med. 2017 Jul;14(1):207-213. doi: 10.3892/etm.2017.4485. Epub 2017 May 22.
The aim of the present study was to evaluate the diagnostic accuracy of second generation dual-energy computed tomography (DECT) myocardial perfusion imaging for the detection of myocardial infarction (MI) in patients with suspected MI. In total, 56 patients underwent DECT. Among those, 40 patients had MI that was detected by catheter coronary angiography and cardiac troponin I elevation and evolution of acute MI detected by electrocardiogram changes. The diagnostic accuracy, including the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the detection of MI were evaluated, as well as the coronary image quality of coronary artery and radiation dose. The sensitivity, specificity, PPV and NPV for the detection of MI were 95.0, 97.0, 86.4 and 98.9%, respectively. Moreover, the image quality was rated excellent (score 1) in 90.2% (515/571), good (score 2) in 6.5% (37/571), adequate (score 3) in 1.9% (11/571) and non-diagnostic (score 4) in 1.4% (8/571) of the coronary segments. The effective radiation dose was on average 6.1±1.5 mSv (3.1-10.9 mSv). Therefore, combined DE iodine maps and coronary CT angiography using the DECT may provide a high diagnostic accuracy for detecting MI with lower radiation exposure in patients with suspected MI.
本研究的目的是评估第二代双能计算机断层扫描（DECT）心肌灌注成像对疑似心肌梗死（MI）患者检测心肌梗死的诊断准确性。共有56例患者接受了DECT检查。其中，40例患者经导管冠状动脉造影检测出心肌梗死，心肌肌钙蛋白I升高，并通过心电图变化检测出急性心肌梗死的演变。评估了检测心肌梗死的诊断准确性，包括敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV），以及冠状动脉的图像质量和辐射剂量。检测心肌梗死的敏感性、特异性、PPV和NPV分别为95.0%、97.0%、86.4%和98.9%。此外，冠状动脉节段的图像质量评为优秀（1分）的占90.2%（515/571），良好（2分）的占6.5%（37/571），尚可（3分）的占1.9%（11/571），非诊断性（4分）的占1.4%（8/571）。有效辐射剂量平均为6.1±1.5 mSv（3.1 - 10.9 mSv）。因此，使用DECT联合DE碘图和冠状动脉CT血管造影术可能为检测疑似MI患者的MI提供高诊断准确性，且辐射暴露较低。
