超声心动图二维斑点追踪成像与心脏核磁共振钆延迟增强对心肌淀粉样变性检测的比较  

Comparison of Two-dimensional Speckle Tracking Echocardiography and Late Gadolinium Enhancement Cardiac MRI for Detecting Cardiac Amyloidosis

作　　者：冀晋[1] 方理刚[1,2] 方全 朱文玲[1] 

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院心内科,北京市100730 [2]北京大学第三医院老年病内科

出　　处：《中国循环杂志》2018年第1期87-91,共5页Chinese Circulation Journal

摘　　要：目的:比较心脏核磁共振(CMR)钆延迟增强与超声心动图二维斑点追踪成像(2D-STE)对心肌淀粉样变性的检测价值。方法:回顾性比较分析10例心肌淀粉样变性CMR钆延迟显像与2D-STE测定的心室收缩期长轴峰值应变。结果:10例患者中CMR均有心室延迟强化,而2D-STE显示9例存在心室收缩期长轴峰值应变减低。两种技术对心肌淀粉样变性左心室受累的诊断一致性为90%。4例患者同时存在双心室的应变异常与CMR延迟强化,4例患者CMR未提示右心室受累但右心室收缩期长轴峰值应变已出现异常,1例CMR提示室间隔延迟强化,左、右心室收缩期长轴峰值应变均下降。结论:2D-STE和CMR对诊断心肌淀粉样变性左心室受累有很好的一致性,2D-STE对右心室心肌淀粉样变性的诊断可能较CMR更敏感。Objective： To compare the efficiency of two-dimensional speckle tracking echocardiography（2 D-STE） and late gadolinium enhancement（LGE） cardiac magnetic resonance（CMR） for detecting cardiac amyloidosis.Methods： Systolic longitudinal peak strain by 2 D-STE and LGE by CMR were retrospectively analyzed in 10 patients with cardiac amyloidosis. Results： CMR showed 10 patients with LGE and 2 D-STE showed 9 patients with ventricular systolic longitudinal peak strain decreasing, the diagnostic consistency of CMR and 2 D-STE was 90%. There were 4 patients having both strain abnormality and LGE at meanwhile, 4 patients without CMR presented right ventricular involvement while with 2 D-STE indicated abnormal right ventricular systolic longitudinal peak strain, 1 patient with CMR presented LGE in ventricular sepatum while 2 D-STE indicated systolic longitudinal peak strain decreasing in both ventricles.Conclusion： 2 D-STE and CMR had good consistency for diagnosing left ventricular involvement in patients with cardiac amyloidosis; 2 D-STE may have better sensitivity for diagnosing right ventricular amyloidosis.

关 键 词：磁共振成像 超声心动描记术 二维 淀粉样变性 

分 类 号：R54[医药卫生—心血管疾病]