三维超声斑点追踪成像对小儿不典型川崎病冠状动脉病变的诊断价值  

Value of speckle tracking imaging of three-dimensional echocardiography in the diagnosis of coronary artery lesions in children with atypical Kawasaki disease

作　　者：姜华[1] 胡尧舜 JIANG Hua;HU Yao-shun(Department of Pediatrics Suining Central Hospital,Suining 629000,China;Department of Pediatrics,West Chirm Guang'an Hospital,Sichuan University,Guang'an 638000,China)

机构地区：[1]遂宁市中心医院儿科,四川遂宁629000 [2]四川大学华西广安医院,儿科,四川广安638000

出　　处：《中国实验诊断学》2021年第8期1117-1120,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析三维超声斑点追踪成像(3DE-STI)在小儿不典型川崎病冠状动脉病变诊断中的应用价值。方法选取遂宁市中心医院105例不典型川崎病患儿,均行冠脉造影、常规超声与3DE-STI检查,比较常规超声与3DESTI对冠脉病变检出情况、冠脉病变组与正常组3DE-STI参数[左室3D整体纵向应变(3D-GLS)、3D整体径向应变(3D-GRS)、3D整体面积应变(3D-GAS)与3D整体周向应变(3D-GCS)]及常规超声参数[左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)及左室射血分数(LVEF)]、不同病变程度组3DE-STI参数。结果常规超声诊断敏感度88.30%,特异度63.64%,准确率85.71%,Kappa值0.41;3DE-STI诊断敏感度96.81%,特异度81.82%,准确率95.24%,Kappa值0.76;3DE-STI对冠脉病变诊断敏感度、准确率明显高于常规超声(P<0.05),两种检查方式诊断特异度无显著差异(P>0.05);病变组与正常组LVEDV、LVESV、LVEF比较无显著差异(P>0.05);病变组3DGLS、3D-GRS、3D-GAS以及3D-GCS明显小于正常组(P<0.05);重度组3D-GLS、3D-GRS、3D-GAS、3D-GCS明显小于轻、中度组(P<0.05),且中度组明显小于轻度组(P<0.05)。结论3DE-STI诊断小儿不典型川崎病冠脉病变与冠脉造影高度一致,相较于常规超声,其诊断敏感度与准确率更高,具有重要应用价值。Objective To analyze the application value of speckle tracking imaging of three-dimensional echocardiography(3 DE-STI)in the diagnosis of coronary artery lesions in children with atypical Kawasaki disease.Methods A total of 105 children with atypical Kawasaki disease who were subjected to coronary angiography,conventional ultrasound and 3 DE-STI examinations were enrolled.The detection of coronary artery lesions by conventional ultrasound and3 DE-STI was compared.Meanwhile,3 DE-STI parameters[left ventricular 3 Dglobal longitudinal strain(3 D-GLS),3 D global radial strain(3 D-GRS),3 Dglobal area strain(3 D-GAS)and 3 Dglobal circumferential strain(3 D-GCS)]and conventional ultrasound parameters[left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF)]of coronary artery lesion group and normal group,3 DE-STI parameters of different severity groups were compared.Results The diagnostic sensitivity,specificity,accuracy and Kappa value of conventional ultrasound were 88.30%,63.64%,85.71%and 0.41,which of 3 DE-STI were 96.81%,81.82%,95.24%and 0.76,respectively.The diagnostic sensitivity and accuracy of 3 DE-STI were significantly higher than those of conventional ultrasound(P<0.05),but there was no significant difference in diagnostic specificity between the two methods(P>0.05).There were no significant differences between the diseased group and the normal group in LVEDV,LVESV and LVEF(P>0.05).The 3 D-GLS,3 D-GRS,3 D-GAS and 3 D-GCS in the diseased group were significantly smaller than those in the normal group(P<0.05),and 3 D-GLS,3 D-GRS,3 D-GAS and 3 D-GCS decreased with the increase of severity(P<0.05).Conclusion 3 DE-STI is highly consistent with coronary angiography in the diagnosis of coronary artery lesions in children with atypical Kawasaki disease.Compared with conventional ultrasound,its diagnostic sensitivity and accuracy are higher,which indicates that it has great application value.

关 键 词：不典型川崎病 患儿 冠状动脉 斑点追踪成像 

分 类 号：R725.9[医药卫生—儿科] R541.4[医药卫生—临床医学]