急性前壁心肌梗死后心脏磁共振和超声心动图评估左心结构功能的对比研究  

Comparative Study of Left Ventricular Structure and Function Evaluated by Cardiac Magnetic Resonance and Echocardiogram After Acute Anterior Myocardial Infarction

作　　者：魏钰龙 林飞[1] 朱森 陈志刚[1] 闫瑞芳[2] 范会军 赵国安[1] WEI Yulong;LIN Fei;ZHU Sen(Department of Cardiology,the First Affiliated Hospital of Xinxiang Medical College,Weihui,Henan Province 453100,P.R.China)

机构地区：[1]新乡医学院第一附属医院心内科,卫辉453100 [2]新乡医学院第一附属医院磁共振科,卫辉453100 [3]新乡医学院第一附属医院超声科,卫辉453100

出　　处：《临床放射学杂志》2023年第3期417-423,共7页Journal of Clinical Radiology

基　　金：河南省高等学校重点科研项目(编号:21A320012);河南省科技攻关专项(编号:212102310350)。

摘　　要：目的评价急性前壁心肌梗死后超声心动图对左心结构及功能测量指标与心脏磁共振的相关性与一致性。方法纳入急性前壁心肌梗死行经皮冠状动脉介入治疗(PCI)患者30例,分别在术后1个月、3个月行M型、二维超声心动图和心脏磁共振检查,将两种超声所测左室舒张末期内(LVDD)、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、每搏输出量(SV)指标与心脏磁共振进行对比分析。结果与心脏磁共振相比,M型超声和二维超声均显著高估LVEF(P<0.05),低估LVEDV(P<0.05),而LVDD无明显差异(P>0.05)。M型超声所测左心结构及功能指标与心脏磁共振相关性中等,组内相关系数(ICC)一致性中等,Bland Altman分析一致性界限较宽,基本可以被临床接受。二维超声检测值与心脏磁共振相关性良好,ICC一致性良好,Bland Altman分析一致性界限较宽,可以被临床接受。结论急性前壁心肌梗死行PCI术后患者心脏评价方面,相较于M型超声,二维超声与心脏磁共振的相关性及一致性更好,可满足临床需求,但如需精确评价左心功能可优先选择心脏磁共振。Objective To evaluate the correlation and consistency between left ventricular structure and function measured by echocardiography and cardiac magnetic resonance(CMR)after acute anterior myocardial infarction.Methods 30 patients were treated with PCI(percutaneous coronary intervention)surgery for acute anterior myocardial infarction.Mmode,two-dimensional echocardiography and CMR were performed at 1 and 3 months after PCI.Left ventricular end-diastolic diameter(LVDD),Left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV)and stroke volume(SV)were measured by two kinds of echocardiography and compared with CMR.Results Compared with cardiac MRI,both M-mode ultrasound and two-dimensional ultrasound overestimated LVEF and underestimated LVEDV,and the difference was statistically significant,but there was no significant difference in LVDD between them and CMR.Compared with CMR,the results measured by M-mode echocardiography are moderately correlated,the intra-group correlation coefficient(ICC)is moderate,and the Bland Altman consistency limit is wider,which can be basically accepted by clinic.Compared with CMR,the results of two-dimensional echocardiography have better correlation,better ICC consistency and wider Bland Altman consistency boundary,it also can be accepted by clinic.Conclusion In terms of cardiac evaluation of patients with acute anterior myocardial infarction after PCI,compared with M-mode echocardiography,the correlation and consistency between two-dimensional echocardiography and CMR is better,which can basically meet the clinical needs,but CMR may be still the first choice for accurate evaluation of left ventricular systolic function and ventricular volume.

关 键 词：急性前壁心肌梗死 经皮冠状动脉介入治疗 左心功能 心脏磁共振 超声心动图 

分 类 号：R542.22[医药卫生—心血管疾病]