目的 探讨双源CT在冠心病患者 存活心肌中的临床评估价值。方法 收 集我院2012年9月至2015年12月期间所 收治的经冠脉造影检查诊断为冠心病 患者42例进行回顾性分析，患者均行 双源CT检查及心肌双核素SPECT显像检 查。以双核素SPECT显像检查结果为基 准，计算双源CT诊断冠心病患者存活 心肌的敏感性、特异性及符合率。结 果 42例患者共714个心肌节段，以双核 素SPECT显像为基准，双源CT对存活心 肌的诊断敏感性为80.0%(120/150)，特 异度为98.9%(549/555)，诊断符合率为 93.7%(669/714)，与双核素SPECT显像结 果相比无统计学意义(P﹤0.05)。结论 双 源CT图像的时间及空间分辨率较高，结合 首过灌注及延迟期强化情况可对心肌存活 情况进行可靠判定，诊断准确性与经济性 均较高，可作为评估冠心病心肌存活情况 的首选检查方法。

Objective To investigate the clinical value of dual-source CT in evaluating viable myocardium in patients with coronary heart disease. Methods A total of 42 patients with coronary heart disease diagnosed by coronary angiography in our hospital between September 2012 and December 2015 were retrospectively analyzed. All patients underwent dual-source CT and dual-isotopic myocardial SPECT imaging examination. Based on the results of dual-isotopic myocardial SPECT imaging examination, the sensitivity, specificity and accuracy of dual-source CT in the diagnosis of viable myocardium in patients with coronary heart disease were calculated. Results There were a total of 714 myocardial segments in 42 cases of patients. Based on the results of dualisotopic myocardial SPECT imaging examination, the sensitivity, specificity and accuracy of dual-source CT in the diagnosis of viable myocardium were 80.0% (120/150), 98.9% (549/555) and 93.7% (669/714) respectively. Compared with the SPECT imaging results, there were no significant differences (P<0.05). Conclusion The time and spatial resolutions of images of dual-source CT are high. Combined with first-pass perfusion and enhancement in delayed phase, the myocardial viability can be reliably determined. The diagnostic accuracy and the economy both are high, which can be used as the first choice to evaluate the myocardial viability in patients with coronary heart disease.