心脏节段性室壁厚度变化在冠心病MRI诊断中的价值  

The Value of the Variance of Segmental Ventricular Wall Thickness in the Diagnosis of Coronary Artery Diseases (CAD)

作　　者：施裕新[1,2] 周康荣[1,2] 陈祖望[1,2] 王佩芬[1,2] 陈财忠[1,2] 黄刚[1,2] 沈继章[1,2] 

机构地区：[1]南通医学院附属医院影像科 [2]上海医科大学附属中山医院放射科

出　　处：《临床放射学杂志》1999年第2期87-89,共3页Journal of Clinical Radiology

摘　　要：目的：探讨节段室壁厚度变化（收缩末期和舒张末期室壁厚度之差）在冠心病诊断中的价值。材料与方法：分析３１例冠心病和１１例正常对照组的ＭＲ电影，判断ＭＲ电影对冠心病的检测率。结果：正常对照组心肌各室壁厚度变化一致（Ｐ＞０．０５），缺血和梗塞心肌节段室壁厚度变化明显小于正常心肌（Ｐ＜０．０５）。室壁厚度变化减小（＜２ｍｍ）对梗塞和缺血心肌节段的检测敏感性为８８．１４％和５３．８５％，特异性为９４．１７％和１００％；结合室壁动态运动将其敏感性可提高到９１．１８％和６１．５４％；室壁厚度变化减少对梗塞和缺血患者病变冠状动脉的检测敏感性为６６．６７％和５７．１４％，特异性为９１．６７％和９２．３０％。其敏感性心肌梗塞组与左心室造影相仿，心绞痛组高于左心室造影（２８．５７％）。结论：节段室壁增厚变化是ＭＲＩ诊断冠心病病变心肌节段和病变冠状动脉较为敏感、可靠的指标。Objective: To investigate the diagnostic value of the variance of segmental ventricular wall thickness for CAD.Materials and Methods:MR cine was analyzed in 31 patients with CAD and 11 health controls. The accuracy of confirmation of CAD diagnosis with MR cine was determined.Results:The variance of segmental ventricular thickness in normal control group was compatible with each other (P>0.05), while the variance in ischemic and infarcted myocardium was significantly lower than that of normal myocardium (P<0.05). Using the variance of segmental ventricular wall thickness less than 2mm as the standard of abnormal, the sensitivity for infarcted and ischemic segments was 88.14% and 53.85%, respectively, and the specificity was 94.17% and 100%, respectively, the former figures could be raised to 91.18% and 61.54% by combining the variance with ventricular wall dynamic movement. Using the same standard, the sensitivity for diseased coronary artery with infarction and ischemia was 66.67% and 57.14%, respectively, and the specificity was 91.67% and 92.30%, respectively. The sensitivity of MR cine for detection of diseased coronary artery in infarction group was similar to that of left ventricular angiography (LVA), while the sensitivity of MR cine in angina was markedly higher than that of LVA.Conclusion: Variance of segmental ventricular wall thickness on MRI was fairly sensitive and reliable for diagnosing of diseased coronary artery and myocardium due to ischemia or infarction.

关 键 词：冠心病 室壁厚度变化 磁共振成像 

分 类 号：R541.404[医药卫生—心血管疾病] R445.2[医药卫生—内科学]