多排CT、实时三维超声心动图和MRI对左心房功能评估的对比研究  

Compariscn study on left atrial function assessment with MDCT,RT-3DE and MRI

作　　者：毕涛[1] 赵映[2] 刘家祎[1] 温兆赢[1] 张兆琪[1] 范占明[1] 

机构地区：[1]首都医科大学附属北京安贞医院放射科,北京100029 [2]首都医科大学附属北京安贞医院超声科,北京100029

出　　处：《医学影像学杂志》2015年第5期792-796,共5页Journal of Medical Imaging

基　　金：北京市自然科学基金(7142047);国家自然科学基金(81401375;81401385;81200166)

摘　　要：目的以核磁共振(magnetic resonance imaging,MRI)为参照,探讨多排CT(multi-detector computed tomography,MDCT)与实时三维超声心动图(real-time 3-dimensional echocardiography,RT-3DE)对左心房容积和功能评估的准确性,以期为临床寻找更可靠、便捷的左心房功能评价方法。方法42例患者,三天内完成MDCT、RT-3DE和MRI检查,然后对原始数据进行后处理及分析。得到左心房最大容积(maximal left atrial volume,LAVmax)、左心房最小容积(minimal left atrial volume,LAVmin),并计算左心房射血分数(left atrial ejection fraction,LAEF)。通过BlandAltman分析法和配对t检验分析MDCT和MRI、RT-3DE和MRI两种检查方法间的一致性。通过Bland-Altman分析法评估MDCT、RT-3DE和MRI操作者测量值的一致性。结果通过MDCT和MRI、RT-3DE和MRI的两两对比,对左心房容积和功能进行测量,所得的测量指标之间差异无显著性(P>0.05)。MDCT和MRI、RT-3DE和MRI对左心房容积和功能测量值的一致性较好。对左心房容积和功能指标的测量结果,操作者间的一致性MDCT优于MRI,MRI优于RT-3DE。结论与MRI相比,MDCT及RT-3DE在左心房容积和功能测量方面准确性均较高,相比起来MDCT更有优势,可"一站式"检查同时评估冠状动脉并且较准确的测量左心房容积及功能。Objective This study was designed to compare the accuracy of multi‐detector computed tomography （MDCT） and real‐time 3‐dimensional echocardiography （RT‐3DE） for left atrial （LA） volume and function assessment with magnetic resonance imaging （MRI） .Methods A total of 42 patients underwent MDCT ,MRI and RT‐3DE examina‐tions within 3 days .LAVmax ,LAVmin ,and LAEF data were obtained .Intermotality agreement was tested through Bland‐Altman analysis and paired t test .Interobserver variability was tested through Bland‐Altman analysis .Results For LAVmax ,LAVmin ,and LAEF measurements ,there was no significant difference by MDCT and RT‐3DE in comparison with MRI （ P〉0 .05） .Furthermore ,MDCT and RT‐3DE showed good intermotality agreement with MRI for LA volume and LAEF .For the interobserver variability ,MDCT was best ,then MRI ,followed RT‐3DE .Conclusion MDCT and RT‐3DE can provide highly reliable measurements of LA volume and function and information .However ,MDCT can ex‐amine coronary artery and cardiac function at the same time .

关 键 词：体层摄影术  X 线计算机 超声心动图 磁共振成像 左心房容积 左心房功能 

分 类 号：R541[医药卫生—心血管疾病]