【摘要】：【目的】 以辛普森法（Simpson）算法為參考標準，探討自動閾值分割（AutomatedThreshold-Based Segmentation）算法評價左心室功能的臨床價值； 運用256層螺旋CT初步探討單純左冠狀動脈前降支狹窄程度與左心室結構功能的關系。 【方法】 將57例行冠狀動脈CT血管造影患者的數據導入后處理工作站，分別采用Simpson和Automated Threshold-Based Segmentation兩種算法對左心室質量（LVM）、收縮末期容積(ESV)、舒張末期容積(EDV)、每搏輸出量(SV)、射血分數(EF)進行評估，將所得結果分別進行配對t檢驗、Pearson相關性分析、Bland-Altman分析。 搜集正常者及單純左冠狀動脈前降支狹窄患者，按照狹窄程度分為正常、輕度、中度、重度四組，，采用單因素方差分析狹窄程度與左心室結構和功能的關系。 【結果】 Simpson和Automated Threshold-Based Segmentation兩種算法具有較好的相關性，ESV、EDV、SV、EF、LVM均為高度相關（r分別為0.96、0.97、0.93、0.94、0.89），Bland-Altman分析示兩種算法所測ESV、EF一致性可被臨床接受，EDV、SV、LVM一致性均不被臨床所接受。 不同狹窄組間，ESV、EDV、SV、EF均無統(tǒng)計學差異，而左室質量指數（LVMI）重度組較正常組增加，差異有統(tǒng)計學意義；中度和重度組，部分節(jié)段舒張期心肌壁較正常組增厚，差異有統(tǒng)計學意義，而收縮期各組間肌壁厚度均無統(tǒng)計學差異。 【結論】 臨床工作中不推薦采用Automated Threshold-Based Segmentation算法進行心臟功能評估。 左前降支不同程度狹窄對左心室ESV、EDV、SV、EF無明顯影響。 左前降支重度狹窄造成左心室質量增加，中度及重度狹窄造成其供血區(qū)部分節(jié)段肌壁厚度增加。
[Abstract]:[objective] to explore the clinical value of automatic threshold segmentation (AutomatedThreshold-Based Segmentation) algorithm in evaluating left ventricular function using Simpson's (Simpson) algorithm as reference standard. The relationship between the degree of stenosis of anterior descending branch of left coronary artery and left ventricular structure and function was preliminarily studied by 256-slice spiral CT. [methods] the data of 57 patients with coronary artery CT angiography were imported into post-processing workstation, and left ventricular mass (LVM), end-systolic volume (ESV), was evaluated by Simpson and Automated Threshold-Based Segmentation algorithms, respectively. The end-diastolic volume (EDV), output (SV), ejection fraction (EF) was evaluated, and the results were analyzed by paired t test, Pearson correlation analysis and Bland-Altman analysis. Patients with left anterior descending coronary artery stenosis were divided into four groups according to the degree of stenosis: normal, mild, moderate and severe. Univariate ANOVA was used to analyze the relationship between stenosis degree and left ventricular structure and function. [results] Simpson and Automated Threshold-Based Segmentation have good correlation, ESV,EDV,SV,EF,LVM is highly correlated (r = 0.960.97). Bland-Altman analysis shows that ESV, measured by the two algorithms is highly correlated. EF conformance can be accepted clinically, but EDV,SV,LVM conformance is not accepted clinically. There was no significant difference in ESV,EDV,SV,EF between different stenosis groups, but the left ventricular mass index (LVMI) in severe group was higher than that in normal group (P < 0.05). In moderate and severe groups, partial diastolic myocardial wall was thicker than that in normal group, but there was no significant difference in contractile myocardial wall thickness. [conclusion] Automated Threshold-Based Segmentation algorithm is not recommended for cardiac function evaluation in clinical work. Left anterior descending branch stenosis had no significant effect on left ventricular ESV,EDV,SV,EF. Severe stenosis of the left anterior descending branch resulted in increased left ventricular mass and increased thickness of some segments of the blood supply area due to moderate and severe stenosis.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R816.2

【參考文獻】

相關期刊論文 前1條

1 段慧;單可記;王菊;韓丹;;雙源CT對冠狀動脈狹窄與左室功能及心肌缺血關系的分析[J];中國醫(yī)學科學院學報;2010年06期

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