实时三维超声测定冠心病患者左心室局部射血分数的准确性及与心脏磁共振成像的对比研究  

Contrast study of accuracy of measurement of left ventricular regional ejection fraction in coronary heart disease with real-time three-dimensional echocardiography and cardiac magnetic resonance imaging

作　　者：刘怡[1] 陈明[1] 范慧敏[1] 陈伟冬[1] 张蕾[1] 高一[1] 郑东燕[1] 刘盛林[1] 宗根林[1] 

机构地区：[1]同济大学附属上海东方医院心脏中心,上海200120

出　　处：《上海交通大学学报（医学版）》2013年第5期667-671,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生局卫生科技面上项目(2009158);浦东新区卫生科技面上项目(PW2006A-6);上海市浦东新区卫生系统重点学科群建设项目(PKzxkq2010-01);上海市浦东新区卫生系统领先人才培养计划项目(PKR2011-01)~~

摘　　要：目的通过与心脏磁共振成像(CMRI)结果的比较,评估实时三维超声技术(RT-3DE)测定冠心病患者左心室局部收缩功能的准确性。方法应用RT-3DE测量32例冠心病患者(冠心病组)和30名健康志愿者(正常对照组)左心室局部射血分数(rEF),并与CMRI结果对照,利用受试者操作特征(ROC)曲线评估RT-3DE测定左心室局部收缩功能的价值。结果正常对照组左前降支供血区的心肌各节段RT-3DE与CMRI所测rEF数值较近似,两种方法测量的数值之间差异无统计学意义(P>0.05);正常对照组左前降支供血区域,从基底段到心尖段rEF的ROC曲线下面积分别为0.927、0.902、0.905、0.898、0.911、0.921和0.915。冠心病组左前降支供血区的心肌各节段RT-3DE的rEF测定值虽较CMRI低,但差异无统计学意义(P>0.05);冠心病组rEF的ROC曲线下面积分别为0.872、0.864、0.842、0.885、0.867、0.822和0.817。结论 RT-3DE能准确评估冠心病患者的左心室局部收缩功能,与CMRI同样具重要的临床应用价值。RT-3DE测定正常人左心室局部收缩功能的价值高于冠心病患者。Objective To evaluate the accuracy of measurement of left ventricular regional ejection fraction in coronary heart disease with real-time three-dimensional echocardiography （RT-3DE） by contrast with cardiac magnetic resonance imaging （CMRI）. Methods Left ventrieular regional ejection fraction was measured with RT-3DE in patients with coronary heart disease （ coronary heart disease group, n = 32） and healthy volunteers （ normal control group, n ： 30）, and the results were compared with those measured with CMRI. The diagnostic value of RT-3DE in left ventricular regional ejection fraction was assessed with receiver operating characteristic （ROC） curve. Results Left ventricular regional ejection fraction of each left anterior descending coronary artery segment measured with RT-3DE was similar to that determined with CMRI in normal control group （P 〉 0.05）, and the areas under ROC curve of left ventricular regional ejection fraction from the base to the apical segments were 0.927, 0.902, 0.905, 0.898, 0.911, 0.921 and 0.915 respectively. Left ventricular regional ejection fraction of each left anterior descending coronary artery segment measured with RT-3DE was lower than that determined with CMRI in coronary heart disease group, while there was no significant difference between them （P 〉0.05）, and the areas under ROC curve were 0. 872, 0. 864, 0. 842, 0. 885, 0. 867, 0. 822 and 0. 817 respectively. Conclusion RT-3DE can accurately evaluate the regional systolic function of left ventricle in patients with coronary heart disease, and may have the similar clinical significance as CMRI. The value of measuring regional systolicfunction of left ventricle with RT-3DE in normal people is higher than that in patients with coronary heart disease.

关 键 词：超声心动描记术 实时三维 冠状动脉疾病 左心室功能 磁共振成像 

分 类 号：R541.4[医药卫生—心血管疾病]