目的 探讨磁共振成像(MRI)与 64层螺旋CT在陈旧性心肌梗死左心功 能评价中的应用。方法 选择我院150 例陈旧性心肌梗死患者为研究对象， 均进行MRI检查和64层螺旋CT检查，均 检测患者左心功能[左室舒张末期容积 (EDV)、收缩末期容积(ESV)、每搏输出 量(SV)、射血分数(EF)和舒张末期心肌 质量(MM)]，并以MRI结果作为标准，评 估64层螺旋CT检测结果信效度和一致 性。结果 64层螺旋CT检查结果中EDV、 ESV、SV、EF和MM与MRI结果均无显著差 异(P>0.05)，其相关性r依次为1.843、 1.217、1.405、1.985和1.326，差异均有 统计学意义(P<0.05)。以MRI检查EF<50% 结果为标准，64层螺旋CT检测灵敏度为 100%(71/71)，特异度为96.20%(76/79)， 准确度为98.00%(147/150)，阳性预测 值为95.95%(71/74)，阴性预测值为 100%(76/76)。64层螺旋CT检查结果与 MRI检查结果一致性检验(κ=1.428， P>0.05)，差异不显著。结论 64层螺旋CT 评价陈旧性心肌梗死患者左心功能灵敏度 和准确度均较高，结果可靠，与MRI一致 性好。

Objective To explore the application of magnetic resonance imaging (MRI) and 64-slice spiral CT in evaluation of left cardiac function in old myocardial infarction. Methods 150 cases of patients with old myocardial infarction in our hospital were selected for the study and were given MRI and 64-slice spiral CT examinations. The left cardiac function [ left ventricular end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and diastolic myocardial mass (MM)] were detected, and the MRI results were taken as the standard, the validity and consistency of detection results of 64 slice spiral CT were evaluated. Results There was no significant difference in EDV, ESV, SV, EF, MM and MRI results between 64-slice spiral CT and MRI (P>0.05), and the correlation r values were 1.843, 1.217, 1.405, 1.985 and 1.326 respectively (P<0.05). The EF<50% of MRI results was taken as the standard, and the sensitivity, specificity, accuracy, positive prediction value and negative predictive value by 64-slice spiral CT detection were 100% (71/71), 96.20% (76/79), 98.00% (147/150), 95.95% (71/74) and 100% (76/76). The consistency between 64-slice spiral CT findings and MRI findings was not significantly different (κ=1.428, P>0.05). Conclusion 64-slice spiral CT can have high sensitivity and accuracy in the evaluation of left heart function in patients with old myocardial infarction, and it can have reliable results and good consistency with MRI.