Abstract:

Objective To investigate the application of dual energy heart imaging in evaluation of coronary artery, first-past myocardial perfusion and left ventricular cardiac function in patients with moderate to severe renal insufficiency. Methods The results of dual energy CT-helical (DECT-helical) in 20 patients confirmed as moderate to severe renal insufficiency were retrospectively analysed, the coronary artery stenosis, myocardial perfusion imaging and cardiac function were evaluated, and the correlation among the three items was explored. Besides, the consistency of heart function analysed by dual-source CT (DSCT) and echocardiogram was determined. Results A total of 248 coronary segments in 20 patients with moderate to severe renal insufficiency were analysed, among whom 14 had different degrees of pathological changes, involving 60 coronary segments, and most patients had multi-vessel lesion with mild stenosis of the lumen. A total of 340 segments of myocardial perfusion were analysed, and 15 patients had perfusion defects, involving 72 myocardial segments. There were significant differences in the iodine values among defective perfusion region, sparse perfusion region and normal myocardium (P<0.01). Twelve patients had abnormal left ventricular cardiac function, among whom 9 had whole cardiac anomalies and 11 had regional wall movement abnormalities, which involved 61 myocardial segments. The consistency of end-diastolic volume, end-systolic volume, stroke volume and ejection fraction between DSCT and echocardiogram was favorable. Conclusion DECT-helical can evaluate the morphology of coronary artery, first-past myocardial perfusion and left ventricular cardiac function in patients with moderate to severe renal insufficiency with appropriate heart rate, and can comprehensively make diagnosis of cardiovascular disease.

Key words: chronic renal insufficiency, coronary artery disease, first-pass myocardial perfusion, left ventricular cardiac function, dual energy CT