【摘要】：目的應(yīng)用64層螺旋CT(MSCT)定量評(píng)價(jià)左心室功能,以M型超聲心動(dòng)圖(UCG)為對(duì)照,探討MSCT與M型UCG對(duì)明確存在室壁運(yùn)動(dòng)異常或室壁瘤(A組)及不存在(B組)室壁運(yùn)動(dòng)異常及室壁瘤患者的左心室功能定量評(píng)價(jià)的相關(guān)性以及一致性。 方法52例擬診冠心病的住院患者,行CT冠狀動(dòng)脈血管造影(CT coronary artery angiography, CTCA)檢查并前后72h內(nèi)行UCG檢查。據(jù)UCG及CTCA后處理電影模式綜合判斷是否存在室壁運(yùn)動(dòng)異常或室壁瘤并分為A、B兩組,A、B組兩種測(cè)量方法分別獲得左心功能指標(biāo)：左室收縮末期容積(left ventricular end-systolic volume, LVESV),左室舒張末期容積(leftventricular end-diastolic volume, LVEDV),左室射血分?jǐn)?shù)(left ventricular ejection fraction, LVEF),搏出量(stroke volume, SV),各組分別對(duì)MSCT及M型UCG所得的左心室心功能各參數(shù)進(jìn)行配對(duì)t檢驗(yàn)、pearson相關(guān)分析,并采用Bland-Altman作圖法進(jìn)一步評(píng)價(jià)MSCT與M型UCG兩種測(cè)量方法的一致性。 結(jié)果存在室壁運(yùn)動(dòng)異常或室壁瘤組(A組)MSCT所測(cè)得LVEF、SV、LVESV、LVEDV值分別為44.04±9.25%,72.41±12.04ml,96.43±31.61ml,168.84±33.00ml,M型UCG所得LVEF、SV、LVESV、LVEDV值分別為58.87±11.22%,83.28±23.35ml,61.04±26.95ml,144.33±42.85ml,A組MSCT和M型UCG得到的心功能指標(biāo)LVEF、LVESV、LVEDV差異有統(tǒng)計(jì)學(xué)意義,且相關(guān)性較低(r=0.208～0.542)；不存在室壁運(yùn)動(dòng)異常或室壁瘤組(B組)MSCT所測(cè)得LVEF、SV、LVESV、LVEDV值分別為60.77±9.60%,68.89±16.59ml,45.52±18.14ml,114.78±25.20ml,M型UCG所得LVEF、SV、LVESV、LVEDV值分別為61.49±11.30%,70.65±17.65ml,44.72±22.03ml,115.36±26.01ml;B組MSCT和M型UCG得到的心功能指標(biāo)LVEF、LVESV、LVEDV、SV差異無統(tǒng)計(jì)學(xué)意義,且相關(guān)性較高(r=0.874～0.941)；Bland-Altman分析進(jìn)一步顯示不存在室壁運(yùn)動(dòng)異常組(B組)MSCT與M型UCG所得的心功能指標(biāo)一致性良好。 結(jié)論MSCT用于左心室功能評(píng)價(jià)時(shí)準(zhǔn)確、可靠,在不存在室壁運(yùn)動(dòng)異常及室壁瘤時(shí)與M型超聲心動(dòng)圖所測(cè)得左心功能指標(biāo)有較高的相關(guān)性且一致性良好,可相互替代。
[Abstract]:Objective to quantitatively evaluate left ventricular function by 64-slice spiral CT (MSCT), with M-mode echocardiography (UCG) as control. To investigate the correlation and consistency between MSCT and M-type UCG in quantitative evaluation of left ventricular function in patients with abnormal wall motion or ventricular aneurysm (group A) and without abnormal wall motion (group B). Methods 52 inpatients with coronary heart disease were examined by CT coronary angiography (CT coronary artery angiography, CTCA) and UCG within 72 hours before and after coronary artery disease. According to the post-processing film mode of UCG and CTCA, the patients with abnormal wall motion or ventricular aneurysm were divided into two groups: group A, group B and group B, respectively. The left ventricular function index was obtained by two methods: left ventricular end-systolic volume (left ventricular end-systolic volume,. LVESV), left ventricular end-diastolic volume (leftventricular end-diastolic volume, LVEDV), left ventricular ejection fraction (leftventricular ejection fraction, LVEF), pulsatile volume) the parameters of left ventricular cardiac function obtained by MSCT and M-type UCG were tested by pairing t test in each group. Pearson correlation analysis and Bland-Altman mapping method were used to further evaluate the consistency between MSCT and M-type UCG. Results the LVEDV values of LVEF,SV,LVESV, measured by MSCT in group A (group A) were 44.04 鹵9.25%, 72.41 鹵12.04ml, 96.43 鹵31.61ml, 16884 鹵33.00ml, respectively. The LVEF,SV,LVESV, obtained by M-type UCG was 44.04 鹵9.25%, 72.41 鹵12.04ml, 96.43 鹵31.61ml, 16884 鹵33.00ml and M-type LVEDV, respectively. The values of LVEDV were 58.87 鹵11.22%, 83.28 鹵23.35ml, 61.04 鹵26.95ml, 144.33 鹵42.85ml, respectively. There was significant difference in LVEF,LVESV,LVEDV between MSCT and M-type UCG in group A, and the correlation was low (r 鈮，

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