左心室超声造影与二维超声心动图对心肌致密化不全的诊断价值比较  

Comparison of the value between the left ventricular opacification and two-dimensional echocardiography in the diagnosis of noncompaction of the ventricular myocardium

作　　者：闫冰 YAN Bing(Department of Ultrasonography,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,Henan Province,China)

机构地区：[1]河南科技大学附属许昌市中心医院超声科,河南许昌461000

出　　处：《新乡医学院学报》2020年第8期754-757,共4页Journal of Xinxiang Medical University

摘　　要：目的比较左心室超声造影(LVO)与二维超声心动图(2DE)在心肌致密化不全(NVM)诊断中的价值。方法选择2017年1月至2019年12月于许昌市中心医院经常规2DE诊断为疑似NVM的38例患者为研究对象,对所有患者进行LVO检查。在收缩末期和舒张末期,观察2种检查方法对致密心肌节段、非致密心肌节段定性显示情况及所有心肌节段的定量差异,分析2种检查方法对NVM的诊断价值。结果38例经2DE检查疑似NVM患者中,经LVO检查确诊为NVM者26例。38例疑似NVM患者的646个心肌节段中,2DE图像舒张末期和收缩末期心肌节段无法清晰显示率分别为5.57%(36/646)、5.73%(37/646),LVO图像舒张末期和收缩末期心肌节段无法清晰显示率均为1.55%(10/646),2DE图像舒张末期和收缩末期心肌节段无法清晰显示率均高于LVO图像(χ2=15.238、16.096,P<0.05)。26例确诊NVM患者的442个心肌节段中,2DE图像舒张末期和收缩末期心肌节段无法清晰显示率均为5.43%(24/442),LVO图像舒张末期和收缩末期心肌节段无法清晰显示率均为0.68%(3/442);2DE图像舒张末期和收缩末期心肌节段无法清晰显示率显著高于LVO图像(χ2=16.848、16.848,P<0.05)。26例确诊NVM患者,在清晰显示的心肌节段中,舒张末期2DE发现25.12%(105/418)的心肌节段出现双层结构,LVO发现34.17%(150/439)的心肌节段出现双层结构;收缩末期2DE发现22.49%(94/418)的心肌节段出现双层结构,LVO发现32.12%(141/439)的心肌节段出现双层结构;在舒张末期和收缩末期,LVO心肌节段双层结构检出率均显著高于2DE(χ2=8.391、9.983,P<0.05)。经2DE和LVO测量的26例NVM患者的左心室射血分数、非致密心肌与致密心肌厚度的比值比较差异均无统计学意义(P>0.05)。结论在NVM诊断中,采用LVO能够获得更加精确的诊断结果,对常规2DE有着重要的补充作用。Objective To compare the value of left ventricular opacification(LVO)and two-dimensional echocardiography(2DE)in the diagnosis of noncompaction of the ventricular myocardium(NVM).Methods Thirty-eight patients with suspected NVM diagnosed by conventional 2DE in Xuchang Central Hospital from January 2017 to December 2019 were selected as the research objects,and all patients were examined by LVO.The qualitative presentation of the compact and non-compact myocardial segments and the quantitative differences of all myocardial segments were observed at the end of systolic and diastolic phase,and the diagnostic value of the two methods for NVM was analyzed.Results Among the 38 patients suspected NVM diagnosed by conventional 2DE,26 cases were diagnosed as NVM by LVO.Among the 646 myocardial segments in the 38 suspected NVM patients,the rate of no clear display of myocardial segments in 2DE images at the end of systolic and diastolic phase was 5.57%(36/646)and 5.73%(37/646),respectively;and the rate of no clear display of myocardial segments in LVO images was 1.55%(10/646).The rate of no clear display of myocardial segments in 2DE images was higher than that in LVO images at the end of systolic and diastolic phase(χ2=15.238,16.096;P<0.05).Among the 442 myocardial segments in the 26 patients with NVM,the rate of no clear display of myocardial segments in 2DE images at the end of systolic and diastolic phase was 5.43%(24/442),and the rate of no clear display of myocardial segments in LVO images was 0.68%(3/442).The rate of no clear display of myocardial segments in 2DE images was higher than that in LVO images at the end of systolic and diastolic phase(χ2=16.848,P<0.05).In the clear myocardial segments of the 26 patients with NVM,25.12%(105/418)and 34.17%(150/439)of myocardial segments showed double-layer structure in 2DE and LVO at the end of diastolic phase,respectively;and 22.49%(94/418)and 32.12%(141/439)of myocardial segments showed double-layer structure in 2DE and LVO at the end of systolic phase,respectively.The

关 键 词：左心室 超声造影术 超声心动图 心肌致密化不全 

分 类 号：R542.2[医药卫生—心血管疾病]