三维超声斑点追踪成像诊断小儿不典型川崎病冠状动脉病变的价值  

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

作　　者：汪慧卿 孙付艳 杜丽娟 赵静 李娜 Wang Huiqing;Sun Fuyan;Du Lijuan;Zhao Jing;Li Na(Department of Ultrasound,the Third People’s Hospital of Henan Province,Zhengzhou 450000,China)

机构地区：[1]河南省直第三人民医院超声科,郑州450000

出　　处：《中国实用医刊》2022年第24期81-84,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析三维超声斑点追踪成像(3DE-STI)诊断小儿不典型川崎病冠状动脉病变的价值。方法抽取2017年3月至2021年7月河南省直第三人民医院收治的不典型川崎病患儿113例,均行常规超声、3DE-STI诊断,以冠状动脉血管造影(CAG)诊断结果为"金标准",统计对比常规超声、3DE-STI诊断小儿不典型川崎病冠状动脉病变的检出结果,比较其诊断效能、诊断预测值,并比较有无冠状动脉病变和不同病变严重程度患儿3DE-STI参数[3D整体周向应变(3D-GCS)、3D整体纵向应变(3D-GLS)、3D整体面积应变(3D-GAS)、3D整体径向应变(3D-GRS)],分析3DE-STI参数和病变严重程度的相关性。结果本组共113例不典型川崎病患儿,CAG检查证实冠状动脉病变101例,冠状动脉正常12例;常规超声诊断出冠状动脉病变93例,冠状动脉正常20例;3DE-STI诊断出冠状动脉病变99例,冠状动脉正常14例。3DE-STI诊断灵敏度(96.04%,97/101)、准确度(94.69%,107/113)均高于常规超声(87.13%,88/101;84.07%,95/113),漏诊率(3.96%,4/101)低于常规超声(12.87%,13/101),P<0.05。冠状动脉病变患儿3D-GCS、3D-GLS、3D-GAS、3D-GRS均低于冠状动脉正常患儿(P均<0.05);经两两比较,不同病变严重程度患儿3D-GCS、3D-GLS、3D-GAS、3D-GRS参数比较差异有统计学意义(P<0.05),重度患儿3D-GCS、3D-GLS、3D-GAS、3D-GRS参数低于轻度、中度患儿(P<0.05)。Pearson分析结果显示,3D-GCS(r=-0.674)、3D-GLS(r=-0.598)、3D-GAS(r=-0.702)、3D-GRS(r=-0.605)和不典型川崎病患儿发生冠状动脉病变均呈负相关(P均<0.05)。结论3DE-STI诊断小儿不典型川崎病冠状动脉病变效果显著,且3DE-STI参数和冠状动脉病变严重程度呈负相关,可为临床评估病情严重程度提供参考。Objective To analyze the value of three-dimensional ultrasound speckle tracing imaging(3DE-STI)in the diagnosis of coronary artery lesions in children with atypical Kawasaki disease.Methods A total of 113 children with atypical Kawasaki disease treated in the Third People’s Hospital of Henan Province from March 2017 to July 2021 were selected,and all of them underwent conventional ultrasound and 3DE-STI diagnosis.The coronary angiography(CAG)diagnosis result was used as the gold standard,the detection results of atypical coronary artery lesions in children with Kawasaki disease diagnosed by conventional ultrasound and by 3DE-STI were statistically recorded and compared;and the diagnostic efficacy and diagnostic predictive value of the two methods were compared.3DE-STI parameters including three-dimensional global circumferential strain(3D-GCS),three-dimensional global longitudinal strain(3D-GLS),three-dimensional global area strain(3D-GAS),three-dimensional global radial strain(3D-GRS)were compared between children with and without coronary artery disease,and among children with different severity of disease.The correlation of 3DE-STI parameters with disease severity was analyzed.Results Among the 113 children with atypical Kawasaki disease in the study,CAG examination confirmed 101 cases coronary artery disease and 12 cases normal coronary arteries;routine ultrasound confirmed 93 cases coronary artery disease and 20 cases normal coronary artery;3DE-STI confirmed 99 cases coronary artery disease and 14 cases normal coronary arteries.The diagnostic sensitivity and accuracy of 3DE-STI were 96.04%(97/101)and 94.69%(107/113),higher than the 87.13%(88/101)and 84.07%(95/113)of conventional ultrasound(P<0.05),and the rate of missed diagnosis(3.96%,4/101)was lower than that of conventional ultrasound(12.87%,13/101),P<0.05.3D-GCS,3D-GLS,3D-GAS,and 3D-GRS in children with coronary artery disease were lower than those in children with normal coronary artery(all P<0.05).By pairwise comparison,there were significant differe

关 键 词：川崎病 冠状动脉病变 三维超声斑点追踪成像 诊断效能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.4[医药卫生—诊断学]