超声心动图与心脏磁共振评估左室收缩功能的对比研究  

Comparison of Echocardiography and Cardiac Magnetic Resonance for the Assessment of Left Ventricular Systolic Function

作　　者：刘德敏[1] 刘晶 武柏林[1] 贾宏宇[1] 谷国强[1] 呼海娟[1] 崔炜[1] LIU Demin;LIU Jing;WU Bailin;JIA Hongyu;GU Guoqiang;HU Haijuan;CUI Wei(The Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第二医院,石家庄050000 [2]山西医科大学第二医院

出　　处：《中西医结合心脑血管病杂志》2022年第2期207-213,共7页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：河北省自然科学基金项目(No.H2018206066);河北省自然科学基金精准医学联合重点项目(No.H2020206409)。

摘　　要：目的评价现实世界中超声心动图与心脏磁共振对左室收缩功能测量的相关性和一致性。方法回顾性收集河北医科大学第二医院同期行超声心动图和心脏磁共振检查的住院病人156例。超声心动图根据病人左室形态及室壁运动情况,选择M型Teichholz法或二维Simpson法测量左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、每搏输出量(SV)、左室射血分数(LVEF)等。心脏磁共振采用3.0T扫描仪,应用平衡式稳态自由进动快速场回波序列采集心脏电影图像,并通过后处理软件计算左室收缩功能参数并与超声心动图结果进行对比分析。结果与心脏磁共振相比,M型超声心动图在全组、射血分数正常亚组和射血分数减低亚组中所测LVEDV、LVESV、SV、LVEF差异均有统计学意义(P<0.05),相关性中等(r值为0.37~0.87,P<0.05)。在两亚组中的一致性较差[组内相关系数(ICC)为0.21~0.45,P<0.05],95%一致性界限超出临床可接受范围。与心脏磁共振相比,二维超声心动图在全组和射血分数减低亚组中所测LVEDV、SV、LVEF差异有统计学意义(P<0.05),LVESV差异无统计学意义(P>0.05);在射血分数正常亚组中LVEDV、LVESV、SV、LVEF差异均无统计学意义(P>0.05),在全组和两亚组中各参数相关性良好(r值为0.66~0.91,P<0.05),一致性中等(ICC为0.47~0.91,P<0.05),95%一致性界限范围可以被临床接受。结论现实世界中无论病人射血分数如何,二维超声心动图Simpson法在左室收缩功能评价方面与心脏磁共振的相关性和一致性较好,可基本满足临床要求,而M型Teichholz法相关性和一致性不良,不建议继续应用。Objective To assess the correlation of left ventricular systolic function measured by echocardiography and cardiac magnetic resonance(CMR)imaging in the real world.Methods A total of 156 hospitalized patients who underwent both echocardiography and CMR were retrospectively enrolled.Echocardiographic values of left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),stroke volume(SV),and left ventricular ejection fraction(LVEF)were measured by M-mode Teichholz method or two-dimensional Simpson′s method according to left ventricular morphology and regional wall motion.CMR was performed by 3.0T scanner,and balanced turbo field echo sequence was performed in cardiac cine scanning.The left ventricular systolic function parameters were calculated by CMR post-processing software and compared with echocardiographic results.Results LVEDV,LVESV,SV,and LVEF measured by M-mode echocardiography were significantly different(P<0.05)and moderate correlated(r value was 0.37~0.87,P<0.05)with CMR in the whole group as well as the normal and reduced ejection fraction(EF)subgroups.In both subgroups,the consistency was weak[intraclass correlation coefficient(ICC)was 0.21~0.45,P<0.05],and the limit of 95%consistency were beyond the clinically acceptable range.Compared with CMR,LVEDV,SV,and LVEF measured by two-dimensional echocardiography were significantly different in the whole group and the reduced EF subgroup(P<0.05),while the difference was not statistically significant in LVESV(P>0.05).There was no significant difference in LVEDV,LVESV,SV,and LVEF in the normal EF subgroup(P>0.05).In the whole group and both subgroups,the correlation was better(r value was 0.66~0.91,P<0.05),and the consistency was moderate(ICC was 0.47~0.91,P<0.05),and the limit of 95%consistency could be accepted in clinical practice.Conclusion In the real world,for the patient′s EF there were close relationship and consistency between the two-dimensional echocardiography Simpson′s method and the CMR in the evaluation of lef

关 键 词：左室收缩功能 左室容积 超声心动图 心脏磁共振成像 评估 

分 类 号：R54[医药卫生—心血管疾病]