[1]李晓娟,刘烁,王艳.慢性完全性闭塞病变CT心肌灌注成像特征及其对冠状动脉侧支循环及存活心肌的评估[J].中国医学物理学杂志,2025,42(8):1063-1067.[doi:DOI:10.3969/j.issn.1005-202X.2025.08.013]
　LI Xiaojuan,LIU Shuo,WANG Yan.CT myocardial perfusion imaging features in chronic total occlusion patients and its evaluation of coronary collateral circulation and viable myocardium[J].Chinese Journal of Medical Physics,2025,42(8):1063-1067.[doi:DOI:10.3969/j.issn.1005-202X.2025.08.013]
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慢性完全性闭塞病变CT心肌灌注成像特征及其对冠状动脉侧支循环及存活心肌的评估()

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
42
期数:
2025年第8期
页码:
1063-1067
栏目:
医学影像物理
出版日期:
2025-08-30

文章信息/Info

Title:
CT myocardial perfusion imaging features in chronic total occlusion patients and its evaluation of coronary collateral circulation and viable myocardium
文章编号:
1005-202X（2025）08-1063-05
作者:
李晓娟; 刘烁; 王艳
新疆维吾尔自治区人民医院放射影像中心， 新疆 乌鲁木齐 830000
Author(s):
LI Xiaojuan;  LIU Shuo;  WANG Yan
Radiological Imaging Center, Peoples Hospital of Xinjiang Urgur Autonomous Region, Urumqi 830000, China
关键词:
慢性完全性闭塞病变; CT; 心肌灌注成像; 侧支循环; 心肌存活
Keywords:
chronic total occlusion computed tomography myocardial perfusion imaging collateral circulation viable myocardium
分类号:
R541.4；R816.2
DOI:
DOI:10.3969/j.issn.1005-202X.2025.08.013
文献标志码:
A
摘要:
目的：探讨慢性完全性闭塞病变（CTO）CT心肌灌注成像特征及其对冠状动脉侧支循环及存活心肌的评估价值。方法：收集50例CTO患者作为研究对象，分别进行CT心肌灌注成像、冠脉造影，分别对心肌灌注正常组、心肌灌注匹配组（静息/负荷均减低）、心肌灌注不匹配组（静息正常、负荷减低）、Rentrop分级0、1、2、3级患者的年龄、体质量指数、性别、慢性病、冠状动脉优势情况、CT心肌灌注成像参数之间的差异进行比较。结果：心肌灌注正常组、心肌灌注匹配组、心肌灌注不匹配组患者年龄、体质量指数之间的差异无统计学意义（P>0.05），性别、慢性病以及冠状动脉优势情况存在统计学意义（P<0.05），CT心肌灌注减低主要以男性、合并慢性病以及右侧冠状动脉优势为主，Rentrop分级0、1、2、3级患者年龄、体质量指数之间的差异无统计学意义（P>0.05），性别、慢性病以及冠状动脉优势情况存在统计学意义（P<0.05），患者侧支循环的开放主要以男性、合并慢性病以及右侧冠状动脉优势为主，心肌灌注正常组、心肌灌注匹配组、心肌灌注不匹配组心肌血流量（MBF）、心肌血容量（MBV）、平均通过时间（MTT）、达峰时间（TTP）之间的差异存在统计学意义（P<0.05）；Rentrop分级0、1、2、3级患者MBF、MBV、TTP、MTT之间的差异存在统计学意义（P<0.05）。结论：不同冠状动脉侧支循环及存活心肌CTO患者CT心肌灌注成像参数存在差异，可作为临床评价的重要依据。
Abstract:
Abstract: Objective To investigate the characteristics of CT myocardial perfusion imaging in chronic total occlusion (CTO) patients and explore its role in assessing coronary collateral circulation and viable myocardium. Methods A cohort of 50 CTO patients were enrolled and underwent both CT myocardial perfusion imaging and coronary angiography. Age, body mass index, gender, chronic comorbidities, coronary artery dominance and CT myocardial perfusion imaging parameters were compared across different patient groups: normal myocardial perfusion, matched myocardial perfusion (reduced resting and stress perfusion), mismatched myocardial perfusion (normal resting but reduced stress perfusion), and Rentrop grade-stratified subgroups (grade 0, 1, 2 and 3). Results No significant differences in age and body mass index were observed among normal myocardial perfusion group, matched myocardial perfusion group (P>0.05). However, gender distribution, chronic comorbidities and coronary artery dominance differed significantly between groups (P<0.05). Myocardial perfusion reduction on CT was predominantly observed in males, particularly those complicated by chronic diseases and right coronary artery dominance. There was no statistical significance in age and body mass index among patients stratified by Rentrop grade (0, 1, 2 and 3) (P>0.05), while significant differences emerged in gender distribution, chronic comorbidities and coronary artery dominance (P<0.05). The opening of collateral circulation predominantly occurred in ?ales? particularly those with chronic comorbidities and ?ight coronary artery dominance?#8204. Significant differences were found in myocardial blood flow (MBF), myocardial blood volume (MBV), mean transit time (MTT) and time to peak (TTP) among normal myocardial perfusion group, matched myocardial perfusion group and mismatched myocardial perfusion group (P<0.05). The differences in MBF, MBV, TTP and MTT ?mong patients stratified by Rentrop grade (0, 1, 2, and 3) were significant (P<0.05). Conclusion Significant differences exist in CT myocardial perfusion imaging parameters among CTO patients with varying degrees of coronary collateral circulation and myocardial viability. These parameters may serve as important clinical evaluation indicators.

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备注/Memo

备注/Memo:
【收稿日期】2024-11-18 【基金项目】新疆维吾尔自治区自然科学基金（2022D01C841） 【作者简介】李晓娟，硕士，研究方向：心血管病的影像诊断，E-mail: linning1900@163.com 【通信作者】王艳，硕士，主任医师，研究方向：心胸疾病的影像诊断，E-mail: drwangxj@163.com
更新日期/Last Update: 2025-09-15