双源CT与三维超声心动图对左心房容积及功能评估的比较  

Left atrial volume and function evaluation by dual source CT:a comparison with real-time three-dimensional echocardiography(RT-3DE)

作　　者：温兆赢[1] 赵映[2] 张兴梅[3] 于薇[1] 张兆琪[1] 

机构地区：[1]首都医科大学附属北京安贞医院放射科,北京100029 [2]首都医科大学附属北京安贞医院超声科,北京100029 [3]北京和睦家医院放射科,北京100016

出　　处：《解放军医学杂志》2010年第6期741-743,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨双源CT(DSCT)对心动周期中不同时相左心房容积和功能的评估价值,并与实时三维超声心动图(RT-3DE)的检查结果进行比较。方法选择2008年6-12月在北京安贞医院进行冠状动脉CT血管造影(CTA)检查的患者50例,男26例,女24例,年龄58±16岁,所有患者均为窦性心律,在同一天完成DSCT和RT-3DE检查,获得左心房、左心室的DSCT容积数据和RT-3DE容积数据,然后分别采用Circulation和Q-LAB心功能分析软件进行数据后处理,获得左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心房开始收缩时的容积(LAVp)并计算左心房功能指标,包括左心房射血分数(LAEF)、左心房存储功能(LARV)、左心房被动收缩功能(LAPV)、左心房主动收缩功能(LAAV)和左心房管道功能(LACV)。所有的左心房容积和功能指标都经体表面积校正。DSCT和RT-3DE所得的左心房容积和功能指标的一致性分析采用配对t检验。操作者间的变异性采用Bland-Altman分析和相关性分析。结果通过两种方法获得的体表面积校正的左心房容积和功能结果无显著性差异(P>0.05)。与采用RT-3DE相比,DSCT得出的左心房容积和功能指标测量值的变异较低。结论 DSCT在评估冠状动脉的同时可以较准确地测定左房容积和功能。Objective To evaluate the effect of dual source CT （DSCT） on left atrial volume and function in different phases of cardiac cycle,and make a comparison with the result drawn by real-time three-dimensional echocardiography （RT-3DE）. Methods Fifty patients with sinus rhythm （26 males and 24 females,aged 58±16yr） who had undergone coronary artery CT angiography （CTA） in Beijing Anzhen Hospital from Jun. 2008 to Dec. 2008 were involved in the present study. All the 50 patients were examined with DSCT and RT-3DE at the same day. Data of left atrium and left ventricle volume were acquired,and then postprocessed with the software of Circulation and Q-LAB heart functional analysis to obtain maximal left atrial volume （LAVmax）,minimal left atrial volume （LAVmin）,left atrial volume at the onset of P wave （LAVp）,left atrial ejection fraction （LAEF）,left atrial reservoir function （LARV）,left atrial passive emptying volume （LAPV）,left atrial active emptying volume （LAAV） and left atrial conduit volume （LACV）. All parameters were normalized to body surface area （BSA）,and the concordance of the parameters was tested through paired t test. Interobserver variability of DSCT and RT-3DE was analyzed by Bland-Altman analyses and linear regression. Results There was no significant difference between DSCT and RT-3DE measurements in indexed left atrial volume and function （all P value 0.05）. The interobserver variability in DSCT measurements was lower than in RT-3DE measurements in indexed left atrial volume and function. Conclusion DSCT can provide not only the information of coronary artery,but also highly reliable measurements of left atrial phasic volume and function at the same time.

关 键 词：CT 双源 超声心动描记术 三维 实时 心房容积 左 心房功能 左 

分 类 号：R540.45[医药卫生—心血管疾病]