实时三维超声自动定量与磁共振评价急性心肌梗死患者左心房容积及功能的对照研究  

A comparative study of real-time three-dimensional ultrasound automatic quantification and magnetic resonance imaging on left atrial volume and function in patients with acute myocardial infarction

作　　者：徐瑞[1] 袁建军[1] 张喜君[1] 申凯凯 陈慧芳 田婧[3] 朱好辉[1] Xu Rui;Yuan Jianjun;Zhang Xijun;Shen Kaikai;Chen Huifang;Tian Jing;Zhu Haohui(Department of Ultrasonography,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Radiology,Henan Provincial People′s Hospital,Zhengzhou 450003,China;Department of Ultrasonography,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院超声科,郑州450003 [2]河南省人民医院放射科,郑州450003 [3]河南中医药大学第一附属医院超声科,郑州450003

出　　处：《中华超声影像学杂志》2021年第5期382-387,共6页Chinese Journal of Ultrasonography

基　　金：河南省科技攻关项目(212102310652);河南省高等学校重点科研项目计划(19B320010);河南省卫健委河南省医学教育研究项目(Wjlx2020380)。

摘　　要：目的应用三维超声心动图(3DE)左房自动定量技术与磁共振对照评价急性心肌梗死(AMI)患者左房容积及功能改变。方法选取2020年3-10月河南省人民医院AMI患者31例为AMI组,30例健康体检者为对照组。分别采用二维超声心动图(2DE)、3DE左房自动定量技术及心脏磁共振(CMR)测量左房最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVpre),左房容积指数(LAVI),左房排空容积(LAEV),左房射血分数(LAEF),左房储备期、管道期、收缩期长轴及圆周应变(LASr、LASr-c,LAScd、LAScd-c,LASct、LASct-c)。比较两组间及2DE、3DE左房自动定量技术、CMR技术间左房各指标差异。应用Pearson相关系数和Bland-Altman分析进行2DE、3DE左房自动定量与CMR技术间比较。采用组内相关系数(ICC)评价2DE、3DE左房自动定量技术及CMR观察者内和观察者间的重复性。结果①组间比较:与对照组相比,AMI组3DE左房自动定量技术测得LAVmax、LAVmin、LAVpre、LAVI、LASct、LASct-c增高,LAEV、LAEF、LASr、LASr-c、LAScd、LAScd-c减低(P<0.05)。②技术间比较:3DE左房自动定量技术测量的LAVmax、LAVmin、LAVpre、LASr、LAScd、LASct与CMR相关性较2DE测值与CMR相关性更显著(均P<0.05);与CMR对比,2DE对LAVmax、LAVmin、LAVpre、LASr、LAScd、LASct的低估值分别为(8.01±4.01)ml、(9.03±4.15)ml、(7.26±2.09)ml、(7.26±1.23)%、(5.02±1.08)%、(6.24±0.43)%(均P<0.05),3DE自动定量技术对LAVmax、LAVmin、LAVpre、LASr、LAScd、LASct的低估值分别为(1.67±0.62)ml、(1.95±0.90)ml、(2.52±0.76)ml、(1.97±0.59)%、(2.03±0.39)%、(1.02±0.30)%(均P>0.05);2DE、3DE左房自动定量技术用时均较CMR减少,分别为(73.34±10.37)s、(12.18±3.24)s,且3DE用时明显少于2DE(均P<0.05)。③重复性检验:2DE、3DE左房自动定量技术及CMR测值观察者内和观察者间的重复性较好。结论3DE左房自动定量技术可有效评价AMI患者左房容积和功能变化情况,具有简便、快速、准确�Objective To study the changes of left atrial volume and function in patients with acute myocardial infarction(AMI)by three-dimensional echocardiography(3DE)and magnetic resonance imaging(MRI).Methods Thirty-one patients with AMI in Henan People′s Hospital from March to October 2020 were selected as AMI group and 30 healthy subjects were selected as control group.The left atrial maximum volume(LAVmax),minimum volume(LAVmin),presystolic volume(LAVpre),volume index(LAVI),emptying volume(LAEV),ejection fraction(LAEF),long axis and circumferential strain(LASr,LASr-c;LAScd,LAScd-c;LASct,LASct-c)were measured by two-dimensional echocardiography(2DE),3DE left atrial automatic quantitative technique and CMR.The differences of left atrial indices between two groups and among 2DE,3DE left atrial automatic quantitative and CMR techniques were compared.Pearson correlation coefficient and Bland-Altman analysis were used to compare 2DE,3DE left atrial automatic quantitative and CMR.Intra-observer and inter-observer repeatability of 2DE,3DE left atrial automatic quantitative technique and CMR were evaluated by intra-group correlation coefficient(ICC).Results①Compared with the control group:LAVmax,LAVmin,LAVpre,LAVI,LASct and LASct-c by 3DE left atrial automatic quantitative increased,while LAEV,LAEF,LASr,LASr-c,LAScd and LAScd-c by 3DE left atrial automatic quantitative technique decreased in AMI group(all P<0.05).②LAVmax,LAVmin,LAVpre,LASr,LAScd,LASct measured by 3DE left atrial automatic quantitative were more strongly related to CMR than that measured by 2DE(all P<0.05).Compared with CMR,2DE underestimated LAVmax,LAVmin,LAVpre,LASr,LAScd,LASct by(8.01±4.01)ml,(9.03±4.15)ml,(7.26±2.09)ml,(7.26±1.23)%,(5.02±1.08)%,(6.24±0.43)%(all P<0.05);3DE left atrial automatic quantitative technique underestimated LAVmax,LAVmin,LAVpre,LASr,LAScd,LASct by(1.67±0.62)ml,(1.95±0.90)ml,(2.52±0.76)ml,(1.97±0.59)%,(2.03±0.39)%,(1.02±0.30)%(all P>0.05);The time-consuming of 2DE and 3DE left atrial automatic quantitative technique

关 键 词：超声心动描记术 三维 心脏磁共振 急性心肌梗死 自动定量技术 心房功能 左 

分 类 号：R542.22[医药卫生—心血管疾病]