心肌磁共振显像、核素心肌灌注显像、超声心动图与X线左心室造影测定左心室功能的对比研究  

A Comparative Study of Cardiac Magnetic Resonance Imaging,Electrocardiogram-Gated Single-Photon Emission Computed Tomography and Echocardiography With Left Ventriculography

作　　者：邬冬梅[1] 汤嘉宁[1] 王慧峰[1] 彭琨[2] 冯艳林[2] 张全斌[3] 

机构地区：[1]太原钢铁公司职工总医院心内科,山西省太原市030003 [2]太原钢铁公司职工总医院放射科,山西省太原市030003 [3]太原钢铁公司职工总医院超声科,山西省太原市030003

出　　处：《中国循环杂志》2006年第6期449-452,共4页Chinese Circulation Journal

摘　　要：目的:评价心肌磁共振显像(MRI)、核素心肌灌注显像和超声心动图对比X线左心室造影(LVG)检测左心室功能的应用价值。方法:46例患者同期分别行左心室造影、心肌磁共振显像、核素心肌灌注显像(30例)及超声心动图(38例)检查,测定左心室功能。将左心室造影作为标准,与其它3种影像学方法比较,行相关性及一致性分析。结果:心肌磁共振显像与左心室造影所测左心室舒张末期容积、收缩末期容积和射血分数的相关系数分别为0.94、0.98、0.96(P均＜0.001),核素心肌灌注显像与左心室造影的相关系数分别为0.82、0.90、0.93(P均＜0.001),超声心动图与左心室造影的相关系数分别为0.66、0.74、0.69(P均＜0.001)。心肌磁共振显像与左心室造影所测舒张末期容积、收缩末期容积和射血分数一致性范围分别为(-21.4±31.8)ml,(-7.7±25.0)ml,(-2.2±8.8)%。核素心肌灌注显像与左心室造影的一致性范围分别为(-36.8±53.1)ml,(-15.2±32.2)ml,(-2.6±11.0)%。超声心动图与左心室造影的一致性范围分别为(-80.9±95.8)ml,(-47.5±96.0)ml,(3.6±21.1)%。结论:心肌磁共振显像检测心功能准确、可靠,与左心室造影相关性明显,一致性好。核素心肌灌注显像与左心室造影亦具有良好的相关性,但一致性偏差。超声心动图左心功能测值较左心室造影有明显偏倚,一致性差。Objective ：To compare of accuracy of cardiac magnetic resonance imaging （ MRI）, electrocardiogram-gated single-photon emission computed tomography （SPECT） and echocardiography with X-ray left ventriculography （LVG） in assessment of left ventficular function. Methods：LVG and MRI were performed in 46 patients, SPECT was performed in 30 patients, and echocardiography was performed in 38 patients, left ventricular function were estimated with MRI, SPECT and echocardiography. The results were compared with the gold standard of LVG. Statistical evaluation of correlation and agreement was done. Results： The correlation between MRI and LVG for end-diastolic volume, end-systolic volume and ejection fraction were 0. 94,0.98 and 0. 96, respectively（ P 〈 0. 001 ）. The correlation coefficiency between SPECT and LVG were 0. 82,0. 90 and 0.93 （ P 〈 0. 001 ）. The correlation coefficiency between echocardiography and LVG were 0. 66,0. 74 and 0. 69 （ P 〈 0. 001 ）. The limits of agreement of end-diastolic volume, end-systolic volume and ejection fraction between MRI and LVG were（ -21.4 ± 31.8 ） ml, （ - 7.7 ± 25. 0） ml and （ - 2.2 ± 8.8） %, respectively. The limits of agreement between SPECT and LVG were（ - 36. 8 ±53.1 ） ml, （ - 15.2 ± 32. 2 ） ml and （ - 2. 6 ± 11.0） %, respectively. The limits of agreement between echocardiography and LVG were （ - 80. 9 ± 95.8 ） ml, （ - 47. 5 ± 96. 0 ） ml and （ 3.6 ± 21.1 ） %, respectively. Conclusion： MRI is reliable and accurat in measuring cardiac function,and shows a high correlation and agrrement between MRI and LVG. It also shows a good correlation but mild agrrement between SPECT and LVG. However, the value in measuring left ventricular function is deviated by echocardiography.

关 键 词：左心室造影 心肌磁共振显像 核素心肌灌注显像 超声心动图 左心室功能 

分 类 号：R541[医药卫生—心血管疾病]