摘要
目的探讨心肌静息首过CT灌注成像对肥厚型心肌病(HCM)患者冠状动脉微循环状态进行半定量评估。方法选取我院收治确诊的HCM患者35例和健康对照组32例,对两组受试者CCTA的数据进行心肌首过灌注分析,测量心肌首过灌注值(MP)、心肌灌注校正值(C-MP)和心肌透壁灌注指数(TPR)。根据舒张末期的心肌厚度,将HCM组心肌节段分为非肥厚亚组(<15 mm)和肥厚亚组(≥15 mm),肥厚亚组又分为轻度肥厚(15~19 mm)、中度肥厚(20~24 mm)和重度肥厚(≥25 mm)三个水平。采用单因素方差分析比较HCM各亚组和对照组的MP、C-MP和TPR的总体差异,采用LSD-t检验对各组间进行两两比较。结果HCM非肥厚亚组与对照组的MP、C-MP和TPR值均无明显统计学差异(P>0.05)。HCM肥厚亚组与对照组以及HCM肥厚亚组与非肥厚亚组之间MP、C-MP和TPR值差异均有统计学意义(P<0.05),表现为肥厚节段较非肥厚节段各参数值较低。在不同肥厚水平的组间比较中,轻度与中度肥厚节段的MP和C-MP值无明显统计学意义(P>0.05),中度肥厚节段的TPR明显低于轻度肥厚组(P<0.05);重度肥厚与中度以及轻度肥厚节段之间各参数均差异明显(P<0.05)。结论CT首过灌注可以对肥厚型心肌病患者心肌微循环的情况进行半定量评价,为临床进行风险分层和治疗决策提供依据。
Objective To evaluate the status of coronary artery microcirculation in patients with hypertrophic cardiomyopathy(HCM)semi-quantitatively by myocardial resting first pass CT perfusion imaging.Methods The data of CCTA in 35 patients with HCM and 32 healthy controls were analyzed retrospectively.The first pass myocardial perfusion(MP),corrected myocardial perfusion(C-MP)and myocardial transmural perfusion ratio(TPR)were measured.According to the end-diastolic myocardial thickness,the myocardial segments in HCM group were divided into non-hypertrophic subgroup(<15 mm)and hypertrophic subgroup(≥15 mm),and hypertrophic subgroup was divided into mild hypertrophic(15~19 mm),moderate hypertrophic(20~24 mm)and severe hypertrophic(≥25 mm).One-way ANOVA was used to compare the overall differences of MP,C-MP and TPR between each subgroup of HCM and the control group,and the LSD t-test was used to compare each group.Results There was no significant difference in MP,C-MP and TPR between HCM non-hypertrophic subgroup and control group.There were significant differences in MP,C-MP and TPR between HCM hypertrophy subgroup and control group,as well as between HCM hypertrophy subgroup and non-hypertrophy subgroup(P<0.05).The parameters of hypertrophic segments were lower than those of non-hypertrophic segments.In the comparison of different hypertrophy groups,the MP and C-MP values of mild and moderate hypertrophy segments were not significantly different,but the TPR values of moderate hypertrophy segments were significantly lower than those of mild hypertrophy groups,and there were significant differences in all parameters between severe and moderate hypertrophy segments and mild hypertrophy segments.Conclusion CT first pass perfusion can semi-quantitatively evaluate the myocardial microcirculation in patients with hypertrophic cardiomyopathy and provide a basis for clinical risk stratification and treatment decision-making.
作者
林有丹
秦斌
LIN Youdan;QIN Bin(Department of Radiology,The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,P.R.China)
出处
《医学影像学杂志》
2021年第7期1141-1145,共5页
Journal of Medical Imaging
基金
南京中医药大学附属医院科技项目(编号:Y2018CX50)。
关键词
肥厚型心肌病
心肌首过灌注
微循环障碍
体层摄影术
X线计算机
Hypertrophic cardiomyopathy
First-pass myocardial perfusion
Microvascular dysfunction
Tomography,X-ray computed
