MSCT、超声心动图与MRI评价左心功能的比较研究

The Comparative Study of MRI,Echocardiography and MSCT in Assessment of Left Ventricular Myocardial Function

目的以磁共振成像（MRI）为对照标准,应用64层螺旋CT（MSCT）,定量评价左心功能,探讨MSCT和MRI心功能评价指标的相关性及MSCT在冠心病左心功能评价中的应用价值;比较同组病例的超声心动图和心脏MRI的左心功能指标,探讨两种方法心功能指标的相关性。资料与方法临床拟诊冠心病的患者32例（均自愿参加）,均行心脏MSCT、MRI和超声心动图检查。结果MSCT和MRI两种方法的心功能指标差异无统计学意义,舒张末期容积（EDV）、收缩末期容积（ESV）、每搏输出量（SV）、左室射血分数（EF）、心肌质量（MM）相关性高（r值=0.78~0.92）;超声心动图和MRI两种方法的心功能指标差异亦无统计学意义,EDV和SV相关性高（r值分别为0.63和0.69）;ESV和EF值相关性中等或低（r值分别为0.41和0.34）。EDV、ESV均值：MSCT〉MRI〉超声心动图;SV均值：MSCT〉MRI和超声心动图;EF均值：超声心动图〉MRI〉MSCT。结论MSCT在左心功能定量评价方面准确、可靠,一次MSCT冠状动脉造影检查可以同时评估冠状动脉狭窄情况和左心室功能。超声心动图也具有重要的临床应用价值,但是MSCT用于定量评价左心功能较超声心动图更准确。

Objective To assess the correlations between multislice computed tomography （MSCT） and echocardiography in assessment of left ventricular myocardial function, and to compare the results with magnetic resonance imaging （MIL1）. Materials and Methods End-diastolic-volume （ EDV）, end - systolic-volume （ ESV）, stroke-volume （ SV）, ejection -fraction （EF）, and myocardial mass （MM） were calculated from 32 patients scheduled for MSCT angiography of the coronaries suspected of coronary artery disease （CAD）. The results from MSCT and echocardiography were compared with MIL1. Results There was no significant difference among the measurements for MSCT and MRI of the ventricular function parameters. A strong correlation between MSCT and MIL1 （r = 0.78- 0.92） was found for all parameters. There was also no significant difference among the measurements for echocardiography and MIL1 of the ventricular function parameters. Echocardiography and MIL1 had good correlation for EDV （r = 0.63） and SV （r = 0.69）, and a low or moderate correlation for ESV （r = 0, 41 ）, and EF （r = 0.34） . However, EDV, ESV, SV, and MM were overestimated with MSCT compared to MIL1, while EF was underestimated in MSCT. Echocardiography revealed overestimation of EF and an underestimation of EDV and ESV. Conclusion A strong correlation between MSCT and MIL1 is found for all parameters. ECG-gated MSCT angiography can evaluate the coronary tree, whereas the analysis of left ventricular parameters provides additional information of cardiac function without further radiation exposure or scan time. Moreover, the functional analysis with MSCT is more accurate than that with echocardiography.