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目的:通过研究评价能谱CT(Spectral CT)成像功能参数的有效性,并探讨这些参数在评估局部梗死心肌图像质量中的临床应用价值。方法:收集我院30例冠心病患者,均在一次扫描中行宝石能谱CT常规冠脉CTA(CCTA)扫描模式和宝石能谱成像(GSI)扫描模式。患者均在一周内行心脏MRI扫描。常规混合能量图像上分析冠状动脉的狭窄程度。分别找出1 min和3 min单光子能量水平的图像上梗死心肌与正常心肌的最佳对比噪声比(optimal CNR)以及对应的最佳单能量值和此能量值的图像噪声值,通过单因数方差分析方法与常规混合能量图像的对比噪声比(CNR)和图像噪声值进行比较。在MRI心肌灌注图像上找出梗死心肌并与能谱CT进行相关性对比。结果:宝石能谱CT共检出梗死心肌36个区域,所有梗死心肌在CCTA图像上均有区域供血冠脉50%以上狭窄(71.7%±16.2%),并且找出的梗死心肌与MRI心肌灌注图像有较高的相关性(r=100%,P=0.00)。1 min、3 min单光子能量水平图像上最佳CNR值明显高于常规混合能量图像CNR值(P<0.05)。1 min、3 min最佳单能量值水平的图像噪声值均低于常规混合能量图像(P<0.05)。结论:能谱CT的GSI能谱成像模式较常规混合能量图像能够明显提高图像质量,从而提高了梗死心肌的检测效率。
OBJECTIVE: To evaluate the effectiveness of imaging parameters of Spectral CT imaging and to explore the clinical value of these parameters in the assessment of myocardial infarction size. Methods: Thirty patients with coronary heart disease in our hospital were enrolled in this study. The conventional coronary CTA (CCTA) scanning mode and Gem Energy Spectrum Imaging (GSI) scanning mode were performed in one scan. Patients underwent a cardiac MRI scan within a week. Coronary artery stenosis was analyzed on conventional mixed energy images. The optimum CNR and the corresponding optimal single energy value and the image noise value of this energy value were obtained by single-photon energy level at 1 min and 3 min respectively. The ANOVA method is compared with the CNR and the image noise values of conventional mixed energy images. Myocardial infarction was found on MRI myocardial perfusion images and correlated with energy spectrum CT. Results: There were 36 regions of myocardial infarction detected by gem energy spectrum CT. All of the infarcted myocardium had more than 50% stenosis (71.7% ± 16.2%) of regional coronary arteries in CCTA images, and myocardial infarction and myocardial perfusion The images have a high correlation (r = 100%, P = 0.00). The best CNR of single photon energy level images at 1 min and 3 min was significantly higher than that of conventional mixed energy images (P <0.05). The image noise values of the best single energy level at 1 min and 3 min were lower than those of the conventional mixed energy images (P <0.05). Conclusion: Compared with the conventional mixed energy image, the GSI spectrum imaging mode of the energy spectrum CT can obviously improve the image quality and improve the detection efficiency of myocardial infarction.