超声心动图与磁共振成像评估二尖瓣反流严重程度准确性的对比分析

Accuracy in Evaluating Severity of Mitral Regurgitation between Echocardiography and MRI:a Contrastive Analysis

目的比较超声心动图与磁共振成像(MRI)评估二尖瓣反流(MR)严重程度的准确性。方法选取2014年1月-2016年1月在榆林市第一医院行超声心动图和MRI检查的MR患者95例,分析超声心动图技师1与技师2、MRI技师1与技师2、超声心动图与MRI评估MR严重程度的一致性,记录所有患者手术情况并分别比较超声心动图与MRI评估的不同严重程度MR患者手术前后左心室舒张末期容积(LVEDV)及其差值;术后LVEDV与MR患者术前二尖瓣反流量的相关性分析采用Pearson相关分析。结果 (1)超声心动图技师1与技师2评估MR严重程度的一致性中等[ICC=0.65,95%CI(0.51,0.75),P<0.01]。MRI技师1与技师2评估MR严重程度的一致性良好[组内相关系数(ICC)=0.90,95%CI(0.85,0.93),P<0.01]。超声心动图与MRI评估MR严重程度的一致性中等[ICC=0.41,95%CI(0.11,0.69),P<0.01]。(2)本组患者中共35例行手术治疗,其中轻度MR患者11例(占31%),中度MR患者14例(占40%),重度MR患者10例(占29%)。(3)术后6个月仅25例患者行超声心动图、MRI检查。超声心动图评估的不同MR严重程度患者手术前后LVEDV比较,差异有统计学意义(P<0.05);但手术前后LVEDV差值比较,差异无统计学意义(P>0.05)。MRI评估的不同MR严重程度患者手术前后LVEDV及其差值比较,差异有统计学意义(P<0.05);MRI评估的中度和重度患者手术前后LVEDV差值大于轻度患者,重度患者手术前后LVEDV差值大于中度患者(P<0.05)。(4)Pearson相关分析结果显示,术后LVEDV与MR患者术前超声心动图评估的二尖瓣反流量无直线相关关系(r=0.29,P=0.10),但与MR患者术前MRI评估的二尖瓣反流量呈正相关(r=0.79,P<0.01)。结论 MRI评估MR严重程度的一致性良好,评估MR严重程度的准确性较超声心动图高。

Objective To compare the accuracy in evaluating severity of mitral regurgitation(MR)between echocardiography and MRI. Methods A total of 95 MR patients underwent echocardiography and MRI examinations were selected in the First Hospital of Yulin From January 2014 to January 2016,consistency in evaluating severity of MR was analyzed between echocardiography technician 1 and technician 2,between MRI technician 1 and technician 2,as well as between echocardiography and MRI,operation condition was recorded,and then LVEDV and its difference value before and after operation that evaluated by echocardiography and MRI were compared in patients with different severity of MR;Pearson correlation analysis was used to analyze the correlation between postoperative LVEDV and preoperative mitral regurgitation volume in patients with MR. Results(1)Consistency in evaluating severity of MR was moderate between echocardiography technician 1 and technician 2[ICC=0.65,95%CI(0.51,0.75),P<0.01]. Consistency in evaluating severity of MR was high between MRI technician 1 and technician 2[ICC=0.90,95%CI(0.85,0.93),P<0.01].Consistency in evaluating severity of MR was moderate between echocardiography and MRI[ICC=0.41,95%CI(0.11,0.69),P<0.01].(2)Of the 95 patients with MR,35 cases underwent operation,including 11 cases(accounting for 31%)with mild MR,14 cases(accounting for 40%)with moderate MR and 10 cases(accounting for 29%)with severe MR.(3)After 6 months of operation,only 25 cases completed both echocardiography and MRI examinations. There was statistically significant difference in LVEDV before and after operation that evaluated by echocardiography in patients with different severity of MR(P<0.05),but no statistically significant difference of difference value of LVEDV before and after operation that evaluated by echocardiography was found in patients with different severity of MR(P>0.05). There was statistically significant difference in LVEDV and its difference value before and after operation that evaluated by MRI in patients with different severity of MR,respectively(P<0.05);difference value of LVEDV before and after operation that evaluated by MRI in patients with moderate to severe MR was statistically significantly greater than that in patients with mild MR,respectively,meanwhile difference value of LVEDV before and after operation that evaluated by MRI in patients with severe MR was statistically significantly greater than that in patients with moderate MR(P<0.05).(4)Pearson correlation analysis results showed that,postoperative LVEDV was positively correlated with preoperative mitral regurgitation volume that evaluated by MRI in patients with MR(r=0.79,P<0.01),but was not linearly correlated with preoperative mitral regurgitation volume that evaluated by echocardiography(r=0.29,P=0.10). Conclusion Consistency of MRI in evaluating severity of MR is high,and the accuracy of MRI in evaluating severity of MR is higher than echocardiography.