三维超声心动图诊断冠状动脉狭窄  

Three-dimensional echocardiography in diagnosis of coronary artery stenosis

作　　者：刘颖[1] 丁康[2] 杜大勇[3] 

机构地区：[1]南方医科大学研究生学院,广东广州510515 [2]中国人民解放军第305医院超声科,北京100017 [3]中国人民解放军第305医院心内科,北京100017

出　　处：《中国医学影像技术》2014年第3期378-381,共4页Chinese Journal of Medical Imaging Technology

基　　金：首都卫生发展科研专项基金(2011-5004-01)

摘　　要：目的 探讨实时三维超声心动图（RT-3DE）推测冠状动脉狭窄的价值。方法 对104例疑似冠心病患者进行RT-3DE检查，推测相关狭窄血管，以冠状动脉造影为金标准计算RT-3DE推测狭窄血管的敏感度、特异度和准确率；根据冠状动脉狭窄程度将患者分为Ⅰ组（血管狭窄50%~74%）、Ⅱ组（血管狭窄75%~90%）和Ⅲ组（血管狭窄91%~100%），比较各组间室壁运动幅度离散度差异。结果 RT-3DE推测LAD、LCX、RCA狭窄和多支病变的敏感度、特异度及准确率分别为86.21%、97.33%、94.23%，70.00%、95.24%、90.38%，73.68%、96.47%、92.31%和61.90%、91.57%、85.58%。Ⅰ组、Ⅱ组和Ⅲ组室壁运动离散度分别为0.41±0.05，0.51±0.21和0.93±0.17，Ⅰ组与Ⅱ组和Ⅲ组差异具有统计学意义（P均〈0.05），Ⅱ组与Ⅲ组差异无统计学意义（P〉0.05）。结论 RT-3DE可较准确推测狭窄冠状动脉，具有重要临床应用价值。Objective To explore the value of real time three dimensional echocardiography （RT-3DE） in diagnosis of coronary artery stenosis. Methods Totally 104 patients with suspected coronary heart disease underwent RT-3DE. The sensitivity, specificity and accuracy of RT-3DE in conjecturing stenosed vessels were calculated taking coronary artery angiography as gold standards. Patients with different degree stenosis were divided into group Ⅰ （angiostenosis 50%—74%）, group Ⅱ （angiostenosis 75%—90%） and group Ⅲ （angiostenosis 91%—100%）. The dispersion of ventricular wall motion measured by RT-3DE was compared. Results The sensitivity, specificity, accuracy of RT-3DE was 86.21%, 97.33%, 94.23% for left anterior descending artery, 70.00%, 95.24%, 90.38% for left circumflex artery, 73.68%, 96.47%, 92.31% for right coronary artery and 61.90%, 91.57%, 85.58% for multiple-vessels. The dispersion of ventricular wall motion of group Ⅰ, Ⅱ and Ⅲ was 0.41±0.05, 0.51±0.21 and 0.93±0.17, respectively. There was significant difference between group Ⅰ and Ⅱ, as well as between group Ⅰ and Ⅲ （both P〈0.05）, but not between group Ⅱ and Ⅲ （P〉0.05）. Conclusion RT-3DE can diagnose coronary artery stenosis accurately, which has considerable clinical value.

关 键 词：超声心动描记术 三维 冠状血管造影术 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]