256层螺旋CT双时相重建评估左心室收缩功能的可行性研究  

Feasibility of left ventricular systolic function assessment with two-phase reconstruction of retrospective ECG-gated 256-slice CT:correlation with Echocardiography

作　　者：孙宏亮[1,2] 邹英华[1] 徐妍妍[2] 王武[2] 

机构地区：[1]北京大学第一医院介入血管外科,北京100034 [2]中日友好医院放射科,北京100029

出　　处：《医学影像学杂志》2014年第5期729-732,752,共5页Journal of Medical Imaging

摘　　要：目的通过与超声心动图检查对比,评估256层螺旋CT冠状动脉成像双时相重建评估左心室收缩功能可行性。方法回顾性分析临床怀疑冠心病62例患者的冠脉CT影像学及超声心动图检查资料。采用多时相重建(间隔5%R-R间期)及双时相重建(同步记录心电图波形选择时相进行重建分析,即Q波峰开始时相定义为舒张末期,T波升支中点开始扫描时相定义为收缩末期)分析分别获得左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室每搏输出量(LVSV)、左心室射血分数(LVEF),并与超声心动图检查结果分别进行对比。所有数据运用MedCalc V11.4.2统计软件处理,P<0.05具有统计学差异。结果 62例患者均顺利完成检查。双时相及多时相分析所得左心室功能各参数与超声心动图检查结果均具有良好一致性。两种方法均与超声心动图检查具有良好相关性(0.838<r<0.997),但运用Bland-Altman分析发现与CT多时相分析相比,双时相重建分析LVEDV、LVESV、LVSV、LVEF值与超声心动图结果之间差异更小(CT双时相-超声差值分别为(6.9±8.9)ml/m2、(0.9±2.6)ml/m2、(6.0±9.0)ml/m2、(1.1±3.6)%;CT多时相-超声LVEDV、LVESV、LVSV、LVEF差值分别为(-7.2±16.5)ml/m2、(5.4±13.1)ml/m2、(-12.6±17.2)ml/m2、(-8.5±10.9)%。结论冠脉CT双时相左心室收缩功能重建分析结果与超声心动图结果具有良好相关性,能够满足临床对左心室收缩功能分析的需要,值得进一步研究与应用。Objective To demonstrate the clinical feasibility of retrospective ECG-gated 256-slice CT with two-phase re-construction to evaluate left ventricular volume and systolic function in comparison with 2-dimensional Echocardiography . Methods Sixty-two patients who underwent coronary CTA and Echocardiography were included in the study .The left ventricular end-diastolic （LVEDV ） and end-systolic volumes （LVESV ） ,stroke volume （LVSV ） ,and ejection fraction （LVEF） were measured using two different methods of cardiac CT and echocardiography .The first method was multi-phase reconstruction method with original cardiac CT images in 13 cardiac phases over the cardiac cycle （every 5% incre-ments of the R-R interval） .The second method was two-phase reconstruction method based on retrospective ECG trigge-ring ：the end-diastolic phase was reconstructed when the reconstruction window was located at the starting point of the QRS complex on ECG .The end-systolic phase was reconstructed when the reconstruction window was located halfway in the ascending T wave on ECG .The left ventricular functional parameters determined by the two reconstruction methods were compared .The results respectively obtained from CT and Echocardiography were also compared .All data were ana-lyzed by MedCalc V11 .4 .2 commercial software using Pearson correlation analyses and Bland-Altman analyses .A value of P ＆lt;0 .05 was considered statistically significant .Results Data from 62 patients were used for this study .The left ven-tricular functional parameters showed good correlation between cardiac CT and Echocardiography （0 .838＆lt; r〈0 .997） . LVEDV ,LVESV ,LVSV and LVEF differences of two-phase CT and Echocardiography （6 .9 ± 8 .9） ml/m2 ,（0 .9 ± 2 .6） ml/m2 ,（6 .0 ± 9 .0） ml/m2 ,（1 .1 ± 3 .6）% showed less than those of multi-phase CT and Echocardiography （-7 .2 ± 16 .5） ml/m2 ,（5 .4 ± 13 .1） ml/m2 ,（-12 .6 ± 17 .2） ml/m2 ,（-8 .5 ± 10 .9）% .Conclusion The two-phase reconstruct

关 键 词：左心室收缩功能 体层摄影术  X线计算机 超声心动图 

分 类 号：R542.22[医药卫生—心血管疾病]