高频心电图联合MRI在隐匿性冠心病诊断中的价值及影像特点观察

Value and Imaging Features of High-frequency Electrocardiogram Combined with MRI in the Diagnosis of Occult Coronary Heart Disease

目的分析高频心电图联合核磁共振成像(MRI)在隐匿性冠心病诊断中的价值并观察其影像学特点。方法对2016年1月-2018年1月于我院拟诊为隐匿性冠心病的140例患者临床及影像学资料进行回顾性整理分析,所有患者均于3个月内接受CAG检查,其中12例5例患者接受高频心电图检查,110例患者接受MRI检查,102例患者同时接受高频心电图检查和MRI检查,以CAG检查结果为金标准,总结不同检查方式对隐匿性冠心病的诊断价值。结果 MRI诊断隐匿性冠心病的灵敏度和特异度分别为0.842和0.933,阳性和阴性预测值分别为0.988和0.483;HFECG诊断隐匿性冠心病的灵敏度和特异度分别为0.949和0.286,阳性和阴性预测值分别为0.957和0.250;高频心电图联合MRI串联诊断的灵敏度和特异度分别为0.833和.417,阳性和阴性预测值分别为0.915和0.250;并联诊断的灵敏度和特异度分别为0.968和0.429,阳性和阴性预测值为分别为0.958和0.500。结论高频心电图与MRI均具有显著的影像学特点,二者联合检测隐匿性冠心病具有一定诊断价值。

Objective To analyze the value of high-frequency electrocardiogram combined with magnetic resonance imaging(MRI)in the diagnosis of occult coronary heart disease and to observe its imaging features.Methods The clinical and imaging data of 140 patients with occult coronary heart disease diagnosed in our hospital from January 2016 to January 2018 were retrospectivly analysised,all patients received CAG examination within 3 months,of the 12 patients,5 patients underwent high-frequency electrocardiography,110 patients underwent MRI,and 102 patients underwent high-frequency electrocardiography and MRI.The results of CAG were used as the gold standard to summarize the different methods of examination for occult coronary heart disease diagnostic value.Results The sensitivity,specificity,positive predictive value and negative predictive value of MRI in the diagnosis of occult coronary heart disease were 0.842,0.933,0.988 and 0.483.The sensitivity,specificity,positive predictive value and negative predictive value of HFECG in the diagnosis of occult coronary heart disease were 0.949,0.286,0.957 and 0.250.The sensitivity,specificity,positive predictive value and negative predictive value of tadem diagnosis of high-frequency electrocardiogram combined with MRI were 0.833,0.417,0.915 and 0.250.The sensitivity,specificity,positive predictive value and negative predictive value of parallel diagnosis were 0.968,0.429,0.958 and 0.500.Conclusion Both high-frequency electrocardiogram and MRI have significant imaging features.The combination of the two has a certain diagnostic value for the detection of occult coronary heart disease.