双源CT评价冠心病患者的左室心功能和室壁运动:与超声心动图的对比研究  

Evaluation of the Global and Regional Left Ventricle Function with Dual-source CT in Patients with Coronary Artery Disease:Compared with Routine Echocardiogram

作　　者：喻杰[1] 陈艳[1] 韩萍[1] 史河水[1] 刘永华[1] 吕清[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022 [2]华中科技大学同济医学院附属协和医院超声影像科,武汉430022

出　　处：《临床放射学杂志》2009年第10期1385-1389,共5页Journal of Clinical Radiology

摘　　要：目的评价双源CT(dual source CT,DSCT)在评估冠心病患者整体心功能和室壁运动与临床常规超声心动图(echocardiogram,ECG)的一致性。资料与方法将25例冠心病患者DSCT冠状动脉成像数据用以心功能评估,估测射血分数(EF)、左室短轴缩短率(FS)和节段性室壁运动,并和ECG对比。结果DSCT和ECG测得25例FS、EF的差异无显著统计学意义(P值分别约0.71,0.26,均>0.05),相关性均良好(r分别约0.86和0.87,P均<0.001);两种方法对室壁运动的判断按病例数和节段数计算一致性均很好(Kappa值分别约0.85、0.86,P均<0.001);DSCT诊断的室壁运动异常节段的室壁增厚率较对侧显著减低(P<0.01)。结论DSCT时间分辨率高,在复杂心率情况下也可完成对整体和节段性左室收缩功能的评估,与ECG一致性良好,能为冠心病的诊断和预后判断提供更有价值的信息。Objective To evaluate the agreement between DSCT and ECG to assess the global and regional left ventricle function in patients with coronary artery disease.Materials and Methods 25 cases of coronary disease underwent DSCT coronary angiography,and the data were used to assess the ejection fraction（EF）and fractional shortening（FS）,and regional wall motion compared with ECG.Results There was no significant difference between DSCT and ECG to evaluate the EF and FS（P〉0.05）,the correlation was also good（r=0.86 and 0.87,P〈0.001,respectively）.The agreement between DSCT and ECG in diagnosing regional wall motion abnormality was good,no matter counted as cases（Kappa=0.85,P〈0.001） or segments（Kappa=0.87,P〈0.001）.The wall thickening fraction of the segments with abnormal motion diagnosed by DSCT were significant lower than that of its opposite segments [（20.55±24.10）% vs（78.63±30.98）%,P〈0.01].Conclusion With the breakthrough of the temporal resolution,DSCT permits accurate assessing left ventricle function even in patients with heart rate variability,and agreement with routine ECG is good.DSCT can provide more information for CAD diagnosis and prognosis.

关 键 词：冠状动脉性心脏病 左室心功能 体层摄影术 X线计算机 超声心动图 

分 类 号：R541.4[医药卫生—心血管疾病]