64层螺旋CT在左心单瓣膜关闭不全患者心功能评估中的应用

Assessing Heart Function of Patients with Single Left Ventricular Valvalar Insufficiency Leision using 64-slice Multi- detector Row CT Angiography

目的探讨64层螺旋CT(64-MDCT)在左心单瓣膜关闭不全患者心功能评估中的应用价值。方法 58例左心单瓣膜关闭不全患者瓣膜置换术前行64-MDCT、超声心动图(Echo)和磁共振(MRI)检查,分别测定其术前常规心功能参数:左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室每搏输出量(LVSV)、左室射血分数(LVEF)和左室有效射血分数(eLVEF),评价64-MDCT和Echo测定的心功能参数与MR1检查结果之间的相关性及三者测定的心功能参数与围术期指标之间的相关性。结果对于左心单瓣膜关闭不全患者,64-MDCT、Echo分别与MRI术前所测的常规心功能参数比较,差异均无统计学意义,前两者测定的常规心功能参数与后者的心功能参数均相关;三者术前所测的LVEF与围术期参数均不相关,而64-MDCT和MRI测定的eLVEF呈中度到高度相关。结论 64-MDCT较之常规的Echo和MRI测定方法,更能准确、迅速、相对低费用的评估左心单瓣膜关闭不全患者的术前心功能。

Objective To evaluate the accuracy of results of heart functions determined by 64-slice multidetector row computed tomography （64-MDCT） in patients with single valvular insufficiency leision in left ventricle. Methods 58 patients with single valvular insufficiency leision in left ventricle were enrolled in this study. Their heart functions were assessed by magnetic resonance imaging （MRI）, 64-MDCT and echocardiography （Echo） respectively. The assessed parameters included left ventricular end-diastolic and end-systolic volume （LVEDV, LVESV）, stroke volume （LVSV）, ejection fraction （LVEF）, and effective ejection fraction （eLVEF）. The correlations between eLVEF and some clinical indicators, such as cardiopulmonary bypass time （CPBT）, ventilation time （VT）, vasoaetive drug used time （VDUT）, and length of ICU stay （ICUST） were analyzed. Results No significant differences were found in the parameters measured by 64-MDCT, Echo and MRL A strong correlation between 64-MDCT and MRI （r： 0.79-0.92） was found with all of the parameters. The eLVEF measured by 64- MDCT and MRI correlated with CPBT, VT, VDUT and ICUST well （r： 0. 56-0. 84）. Conclusion 64-MDCT is a rapid, accurate and cheap choice for assessing heart functions of patients with single valvular insufficiency leision in left ventricle, eLVEF is a good predictor for the outcomes of operations.