| Results of SPECT myocardial adenosine stress and rest perfusion scans are set to be criteria for myocardial ischemia. To explore a way to evaluate the feasibility of myocardial ischemia by CT coronary artery angiography with Gensini scoring.Materials and methods48 outpatients suspected coronary heart disease were examined with CT coronary angiography (CTCA) and SPECT myocardial perfusion imaging. coronary angiography was conducted by the Siemens dual-source CT (SOMATOM definition).70-80ml Ultravist (370mgI/ml) and 40ml 0.9% normal saline were injected into cubital vein by high-pressure double-barrel syringe at rate of 4-5ml/s. CT Data were transferred to GE workstation (Advantage workstation 4.4) for further analysis. Calculate the stenosis of coronary artery lesion by remain area of the cross section. SPECT scanner was made by U.S. company GE, model VG. Patients got out of anti-angina drugs (nitrates,βblockers, calcium antagonists) 12-24 hours ahead of test. And coffee, tea were hanged. Adenosine was injected at the dosage of 0.14mg/(kg.minute) for at least 6 minutes by intravenous pump.3 minutes later 740 MBq 99mTc-MIBI was pumped into venous. CTA data were calculated according to Gensini scoring method,and then compared with results of SPECT. according to SPECT results, patients were divided into three groups. Group A:Both adenosine stress and rest perfusion scans got positive result. Group B:adenosine stress got a positive result, while rest perfusion got a negative result. Group B:Both scans got negative results. Then compare the difference of Gensini score and ejecting fraction between A,B,C groups. Taking 15 segment model as a criteria,we divided patients into four groups. Group S:none of the lesion got a stenosis more than 25%. Group G:The stenosis of lesions was between 25% and 50%. Group D:The stenosis of lesions were between 50% and 75%. Group F:The stenosis of lesions were higher than 75%. Then compare the relationship between stenosis and results of SPECT, especially with group A, B, C. Patients were divided by the site of lesion. We divided patients into four groups according to the number of culprit bronchial lesions. Patients without coronary lesions detected by CTA; patients with only one branch of lesions; patients with two branches of lesions; patients with three branches of lesions; then describe the description in group A, B, C. all result and data were expressed by means and confidence intervals. The relationship between group A and B was analyzed by SPESS 13.0 by two independent sample T-test and crosstabχ2 tests. p<0.05 was taken to be as statistically significant and P<0.01 for significant statistical significance.ResultsGroup A got 24 cases, group B got 20 cases, group C got 4 cases. There was statistically difference between group A and B by means of Gensini scoring, (P<0.05, P=0.004). There was no difference between group A and B by means of ejecting fraction, but group B got higher mean EF of 0.62 than that of group A (0.57). When referred to stenosis range, There was statistically difference between group A and B (P <0.05, P=0.004). When considered branches of lesions alone, There was no statistically difference between group A and B.Patients suspected CHD who got lesions on three major branches got a higher probability of myocardial ischemia.ConclusionGensini scoring succeeded in evaluating the feasibility of myocardial ischemia by CCTA and reflecting the seriousness to a certain extent.
|
PDF Full Text Request