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目的探讨慢性心功不全(CCI)患者MSCT肺灌注成像(MSCT-PPI)与临床心功能的相关性。方法我院住院治疗的CCI患者24例为CCI组,其中心功能Ⅰ级8例、Ⅱ级7例、Ⅲ级9例。正常成人对照组共28例。对所有对象的上下两个肺野行MDCT-PPI扫描,在胸膜下肺野12个区域设置兴趣区,获得兴趣区首过期时间-密度曲线(TDC),并取强化峰值(PE)、强化增量(PEI)、强化起始时间(TTE)、达峰时间(TTP)、首过时间(TFP)进行统计对照分析。结果肺实质灌注量化参数PE、PEI在24例CCI组三个级别间及其与对照组间无统计学差异。肺实质灌注时相参数TTE、TTP、TFP在CCI组三个级别间存在显著统计学差异(P=0.001);其中TTP在心功能不全组三个级别分别为(17.3±1.0)s、(20.6±2.0)s、(23.8±2.7)s,三个级别间存在显著统计学差异(P=0.001);正常组为(18.6±1.6)s,Ⅱ、Ⅲ级组与对照组存在显著统计学差异(P<0.05);Ⅰ级组与对照组间无统计学差异。各组时相参数数据均与CCI程度显著相关。结论对慢性心功能不全24例行MSCT-PPI表明,肺实质血流灌注时相延迟与心功能分级具有显著相关性,有助于心功能异常诊断及分级。肺血流灌注量变化对本研究中心功能不全患者的判断无显著意义。
Objective To investigate the correlation between MSCT pulmonary perfusion imaging (MSCT-PPI) and clinical cardiac function in patients with chronic heart failure (CCI). Methods Twenty-four CCI patients hospitalized in our hospital were treated with CCI. There were 8 patients with grade Ⅰ in the center, 7 patients with grade Ⅱ and 9 patients with grade Ⅲ. The normal adult control group a total of 28 cases. The MDCT-PPI scans of the upper and lower lung fields of all subjects were performed, and the region of interest was set in 12 regions of the subpulmonary field to obtain the TDC of the region of interest, and the peak value (PE) (PEI), TTE, TTP and TFP were compared statistically. Results Pulmonary parenchymal perfusion quantitative parameters PE, PEI in the 24 CCI group of three levels and between the control group no significant difference. The parameters of TTE, TTP and TFP were significantly different between the three CCI groups (P = 0.001). The levels of TTP were (17.3 ± 1.0) s and (20.6 ± 2.0) s, (23.8 ± 2.7) s, there was a significant statistical difference between the three levels (P = 0.001); in the normal group (18.6 ± 1.6) s, there was significant difference between the Ⅱ and Ⅲ groups and the control group P <0.05). There was no significant difference between Ⅰ group and control group. The phase parameters of each group were significantly correlated with the degree of CCI. Conclusion The MSCT-PPI of 24 patients with chronic cardiac insufficiency shows that the phase delay of pulmonary parenchymal perfusion has a significant correlation with cardiac function classification, which is helpful for the diagnosis and grading of cardiac dysfunction. Pulmonary perfusion changes in the study of patients with functional insufficiency did not have significant significance.