缩窄性心包炎的超声、CT与MRI联合研究  

Integrated Multimodality Imaging Research Including Transthoracic Echocardiography,CT and MRI in the Diagnosis and Management of Constrictive Pericarditis

作　　者：王海燕[1] 马振申[2] 丁红宇[1] 仉晓红[1] 宫玉玲[1] 侯应龙[3] 

机构地区：[1]山东大学附属千佛山医院超声诊疗科,济南市250014 [2]山东大学附属千佛山医院影像科,济南市250014 [3]山东大学附属千佛山医院心内科,济南市250014

出　　处：《中国超声医学杂志》2014年第2期125-130,共6页Chinese Journal of Ultrasound in Medicine

摘　　要：目的联合超声心动图、CT及MRI探讨缩窄性心包炎(CP)的特征性影像学表现。方法回顾性分析30例经手术及病理证实的CP患者经胸超声心动图(TTE)及CT资料,其中11例加做MRI;以手术结果作为金标准,计算TTE、CT及MRI的CP检出率,并进行对比。术后行TTE随访手术疗效。结果 TTE、CT及MRI诊断CP的符合率分别为83.3%、76.7%及90.9%,差异无统计学意义。术后TTE示所有患者左室舒张功能明显改善。结论 TTE是诊断CP的首选与重要方法,CT及MRI能提供较多术前评估、预测术后等信息,联合应用这三种影像学技术能够降低误、漏诊率,为CP治疗和预后判断提供可靠依据。Objective To explore the role of multimodality imaging including echocardiography,CT and MRI in the diagnosis and management of constrictive pericarditis（CP）.Methods 30 CP patients diagnosed by transthoracic echocardiography and CT （Of which 11 cases performed by MRI） were retrospectively analyzed.All cases were compared with surgical findings,and the detection rates of CP by these three technologies were compared using the chisquared test.TTE was used to evaluate the effect after pericardiectomy.Results Some common imaging characteristic performances of CP were shown by TTE,CT and MRI.The diagnostic accuracy rate of TTE,CT and MRI was 83.3 ％,76.7 ％ and 90.9 ％,respectively.There were no significant difference between TTE,CT and MRI in diagnosis of CP （x2=1.185,P=0.553）.TTE after pericardiectomy demonstrated early annular diastolic velocities of mitral valve decreased significantly after pericardiectomy.Conclusions TTE is the first choice of method to diagnose CP,CT and MRI may provide more information about evaluation in preoperative planning and forecast of postoperative effect.So an integrated multimodality imaging strategy can decrease the misdiagnosis rate and provide reliable basis for early treatment and prognosis of CP.

关 键 词：缩窄性心包炎 超声心动描记术 体层摄影术 X线计算机 磁共振成像 

分 类 号：R542.11[医药卫生—心血管疾病] R445[医药卫生—内科学]