双源CT与MRI在主动脉瓣病变患者置换术前心功能诊断中应用观察  

Application of Dual-source CT and MRI in the Diagnosis of Cardiac Function in Patients with Aortic Valve Disease before Replacement

作　　者：徐勇[1] 李明秋[1] XU Yong;LI Ming-qiu(Department of Cardiac Surgery,Wuxi People's Hospital,Wuxi 214000,Jiangsu Province,China)

机构地区：[1]无锡市人民医院心外科,江苏无锡214000

出　　处：《中国CT和MRI杂志》2021年第3期68-71,共4页Chinese Journal of CT and MRI

摘　　要：目的以核磁共振成像(MRI)为对照标准,探讨双源CT用于主动脉瓣病变患者置换术前心功能诊断评估的价值,以指导临床应用。方法分层整群抽样,回顾分析2018年2月至2019年1月在我院诊断为主动脉瓣病变并择期接受主动脉瓣置换术治疗的54例患者的临床资料,全部患者术前均接受MRI及双源CT成像检查。经MRI与双源CT专业心功能分析软件分别测量并计算患者左心收缩末期容积(ESV)、左心舒张末期容积(EDV)、左室射血分数(LVEF)及每搏输出量(SV),各指标均测量三次并取平均值。对比不同方法检测各指标水平的情况,分析不同检测方法各指标间的相关性,经组内相关系数(ICC)描述验证双源CT与MRI的一致性。结果双源CT测得的EDV、SV、LVEF水平均略高于MRI检测结果 ,ESV水平则略低于MRI,但差异无统计学意义(P>0.05);MRI与双源CT所得ESV、EDV、LVEF、SV水平均呈正相关(r>0,P<0.05);双源CT检测的各心功能相关指标水平与MRI所得结果一致性ICC值范围为0.942~0.998,几乎完全一致(P<0.05)。结论双源CT用于主动脉病变置换术前心功能定量评价重复性好且结果准确可靠,可一次评估患者冠狭窄情况及左心功能,不会增加放射剂量,安全性好,能够为主动脉瓣置换术合理手术的制定提供更多有价值的参考信息。Objective Magnetic resonance imaging(MRI) is used as the contrast standard to investigate the value of dual-source CT in diagnosing and evaluating cardiac function in patients with aortic valve disease before replacement as to guide the clinic.Methods The stratified cluster sampling was adopted.The clinical data of 54 patients diagnosed with aortic valve disease with selective aortic valve replacement from February 2018 to January 2019 were retrospectively analyzed.All patients underwent MRI and dual-source CT examination before surgery.The left ventricular end-systolic volume(ESV),left ventricular end-diastolic volume(EDV),left ventricular ejection fraction(LVEF),stroke volume(SV)were measured and calculated by MRI and dual-source CT professional cardiac function analysis softwa re,each indicator was measu red three times and took the average.The levels of indexes were detected by different methods,and the correlation between indexes was analyzed by the different detection methods.The consistency of dual-source CT and MRI was verified by interclass correlation coefficient(ICC).Results The levels of EDV,SV,and LVEF measured by dual-source CT were slightly higher than those measured by MRI,and the ESV level was slightly lower than MRI,but the difference was not statistically significant(P>0.05);There was a positive correlation in ESV,EDV,LVEF and SV levels between MRI and dual-source CT(r>0,P<0.05);The ICC value of dual-source CT and MRI in the detection of cardiac function indexes was 0.942 to 0.998,which was almost identical(P<0.05).Conclusion Dual-source CT for quantitative cardiac function assessment before the aortic valvular disease is accurate,reliable,and reproducible.One-time dual-source CT coronary angiography can evaluate left ventricular function and coronary stenosis without increasing radiation dose,which can provide more critical reference information for cardiac function assessment before aortic valvular replacement and the development of su rgical schemes.

关 键 词：主动脉瓣病变 置换术 双源CT MRI 心脏功能 诊断价值 

分 类 号：R542.52[医药卫生—心血管疾病] R445.3[医药卫生—内科学]