64层螺旋CT冠状动脉血管造影“一站式”二尖瓣环收缩期运动参数测量对左心室收缩功能不全的诊断价值  

Diagnostic value of 64-slice spiral CT coronary artery CTA"one-stop"measurement of mitral annular systolic motion parameters in left ventricular systolic dysfunction

作　　者：李旭文 杜秀娟 王夕富[3] Li Xuwen;Du Xiujuan;Wang Xifu(Department of Radiology,Sijing Hospital,Songjiang District,Shanghai,201600,China;不详)

机构地区：[1]上海市松江区泗泾医院放射科,201600 [2]上海市松江区泗泾医院心内科,201600 [3]上海交通大学附属第一人民医院放射科

出　　处：《实用医学影像杂志》2021年第5期452-455,共4页Journal of Practical Medical Imaging

基　　金：上海市松江区科技攻关项目(19SJKJGG44)。

摘　　要：目的研究二尖瓣环收缩期运动相关参数[二尖瓣环平面收缩期位移(MAPSE)、二尖瓣环平面收缩期移动速度(MAPSMV)、左心室长轴应变(LAS)]与左心室收缩功能的关系,评估64层螺旋CT冠状动脉血管造影“一站式”二尖瓣环收缩期运动相关参数测量对于左心室收缩功能不全的临床诊断价值。方法采用64层螺旋CT回顾性心电门控扫描技术对纳入研究的对照组(23名健康志愿者)、研究组(23例EF≥50%的左心室收缩功能不全患者)进行冠状动脉CTA检查,基于所获冠状动脉CTA图像数据测量2组二尖瓣环收缩期运动相关参数及左心室射血分数(LVEF),对2组间二尖瓣环收缩期运动相关参数及LVEF进行对比分析。结果研究组LVEF略低于对照组,二者间差异无统计学意义(t=1.42,P=0.16);研究组二尖瓣环收缩期位移(MAPSE)、二尖瓣环收缩期位移指数(MAPSEI)、二尖瓣环平面收缩期移动速度(MAPSMV)、二尖瓣环平面收缩期移动速度指数(MAPSMVI)、右心室长轴应变(LAS)参数低于对照组,2组间差异有统计学意义(P<0.05);MAPSE、MAPSEI、MAPSMV、MAPSMVI、LAS诊断EF≥50%左心室收缩功能不全的受试者工作特征曲线(ROC)曲线下面积分别为0.835、0.773、0.767、0.698、0.721,整体诊断准确性处于中到低水平。结论基于64层螺旋CT冠状动脉CTA的“一站式”二尖瓣环收缩期运动相关参数测量具有操作简单、重复性好的优点,可以在未额外增加X线辐射剂量及造影剂剂量前提下使受检者同时获得冠状动脉血管及左心室收缩功能相关信息,可以为诊断EF值尚处于正常范围的左心室收缩功能不全患者提供客观依据,在血管相关性射血分数保留型心力衰竭的诊断方面具有乐观的临床应用前景。Objective To study the relationship between mitral annulus systolic motion-related parameters[mitral annular plane systolic excursion(MAPSE),Mitral annulus plane Systolic movement velocity(MAPSMV),left ventricular long axis strain(LAS)]and left ventricular systolic function,To evaluate the clinical value of 64-slice spiral CT coronary artery CTA"one-stop"measurement of mitral annular systolic motion-related parameters in the diagnosis of left ventricular systolic dysfunction.Methods Coronary artery CTA examinations were performed in the control group(23 healthy volunteers)and the study group(23 patients with left ventricular systolic dysfunction with EF≥50%)using 64-slice spiral CT Retrospective ECG gating scanning technique.Based on the obtained coronary CTA image data,the two sets of mitral annulus systolic motion-related parameters and left ventricular ejection fraction(LVEF)were measured,The parameters related to mitral annular systolic movement and LVEF between the two groups were compared.Results The LVEF of the study group was slightly lower than that of the control group,and there was no significant difference between the two(t=1.42,P=0.16).The MAPSE、MAPSEI、MAPSMV、MAPSMVI、LAS parameters of the study group were lower than those of the control group,and the difference between the two groups was significant(P<0.05).The area under the ROC curve of MAPSE、MAPSEI、MAPSMV、MAPSMVI、LAS is 0.835,0.773,0.767,0.698,0.721,in the diagnosis of EF≥50%left ventricular systolic insufficiency,diagnostic accuracy is moderate to low.Conclusion“One-stop”measurement of mitral annular systolic motion parameters based on 64-slice spiral CT coronary artery CTA has the advantages of simple operation and good repeatability.Without additional X-ray radiation dose and contrast agent dose,the subject can obtain information about coronary artery blood vessels and left ventricular systolic function at the same time,which can provide objective diagnosis for patients with left ventricular systolic insufficiency whose

关 键 词：二尖瓣环平面收缩期位移 左心室长轴应变 二尖瓣环平面收缩期移动速度 左心室收缩功能不全 冠状动脉CTA 一站式 

分 类 号：R816.2[医药卫生—放射医学] R541.4[医药卫生—临床医学]