【作者】 李晓娇；

【导师】 李健丁；

【作者基本信息】 山西医科大学 ， 影像医学与核医学， 2012， 硕士

【摘要】 目的应用64层螺旋CT(MSCT)定量评价左心室功能,以M型超声心动图(UCG)为对照,探讨MSCT与M型UCG对明确存在室壁运动异常或室壁瘤(A组)及不存在(B组)室壁运动异常及室壁瘤患者的左心室功能定量评价的相关性以及一致性。方法52例拟诊冠心病的住院患者,行CT冠状动脉血管造影(CT coronary artery angiography, CTCA)检查并前后72h内行UCG检查。据UCG及CTCA后处理电影模式综合判断是否存在室壁运动异常或室壁瘤并分为A、B两组,A、B组两种测量方法分别获得左心功能指标：左室收缩末期容积(left ventricular end-systolic volume, LVESV),左室舒张末期容积(leftventricular end-diastolic volume, LVEDV),左室射血分数(left ventricular ejection fraction, LVEF),搏出量(stroke volume, SV),各组分别对MSCT及M型UCG所得的左心室心功能各参数进行配对t检验、pearson相关分析,并采用Bland-Altman作图法进一步评价MSCT与M型UCG两种测量方法的一致性。结果存在室壁运动异常或室壁瘤组(A组)MSCT所测得LVEF、SV、LVESV、LVEDV值分别为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值分别为58.87±11.22%,83.28±23.35ml,61.04±26.95ml,144.33±42.85ml,A组MSCT和M型UCG得到的心功能指标LVEF、LVESV、LVEDV差异有统计学意义,且相关性较低(r=0.208～0.542)；不存在室壁运动异常或室壁瘤组(B组)MSCT所测得LVEF、SV、LVESV、LVEDV值分别为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值分别为61.49±11.30%,70.65±17.65ml,44.72±22.03ml,115.36±26.01ml;B组MSCT和M型UCG得到的心功能指标LVEF、LVESV、LVEDV、SV差异无统计学意义,且相关性较高(r=0.874～0.941)；Bland-Altman分析进一步显示不存在室壁运动异常组(B组)MSCT与M型UCG所得的心功能指标一致性良好。结论MSCT用于左心室功能评价时准确、可靠,在不存在室壁运动异常及室壁瘤时与M型超声心动图所测得左心功能指标有较高的相关性且一致性良好,可相互替代。更多还原

【Abstract】 Objective To assess the correlations and consistency between64-slice computed tomography(MSCT) and ultrasound cardiogram(M-mode UCG) in assessment of left ventricularmyocardial function in the patient who have regional wall motion abnormality (RWMA)orventricular aneurysm(group A)and not have regional wall motion abnormality (RWMA)orventricular aneurysm(group B).Method52patients who suspected of coronary artery disease underwent (MSCT) coronaryangiography and M-mode ultrasound cardiogram (M-mode UCG) within72hours wasdivided into two groups (A and B) according to whether have regional wall motionabnormality (RWMA)or ventricular aneurysm. The left ventricular end-systolic volume LVESV,left ventricular end-diastolic volume LVEDV,left ventricular ejection fraction LVEF), stroke volume SV of group A and B from MSCT were compared with M-modeUCG using Paired t test Pearson correlation, and made consistency checking by Bland-Altman.Result LVEF SV LVESV LVEDV of group A from MSCT were44.04±9.25%è72.41±12.04ml è96.43±31.61ml è168.84±33.00ml, LVEF SV LVESV LVEDV of group Afrom M-mode UCG were58.87±11.22%è83.28±23.35ml è61.04±26.95ml è144.33±42.85ml,LVEF, LVESV, LVEDV determined with MSCT and M-mode UCG werestatistically different in group A, the correlation was low (r=0.208~0.542). LVEF SV LVESV LVEDV of group B from MSCT were60.77±9.60%è68.89±16.59ml è45.52±18.14ml è114.78±25.20ml, LVEF SV LVESV LVEDV of group B from M-modeUCG were61.49±11.30%è70.65±17.65ml è44.72±22.03ml è115.36±26.01ml,There wasno significant difference between MSCT and M-mode UCG to evaluate ventricularfunction parameters in group B, the correlation was also good (r=0.874~0.941).Bland-Altman analysis showed a close agreement between MSCT and M-mode UCG forLVEF SV LVESV and LVEDV in group B (without regional wall motion abnormality(RWMA)or ventricular aneurysm).Conclusion The data of left ventricular function measured with MSCT were accurateand reliable, and has good correlation with M-mode UCG without having regional wall motionabnormality (RWMA)or ventricular aneurysm.更多还原