二次谐波成像对二维超声心动图测定左心室整体和局部功能的影响：与心肌灌注显像门控单光子发射计算机断层扫描的比较

Impact of second harmonic imaging on the determination of the global and regional left ventricular function by 2D echocardiography: a comparison with MIBI gated SPECT.

作者信息

Van Camp G, Franken R R, Schoors D, Hagers Y, Koole M, Demoor D, Melis P, Block P

机构信息

Department of Cardiology, Academic Hospital of the Free University of Brussels, Belgium.

出版信息

Eur J Echocardiogr. 2000 Jun;1(2):122-9. doi: 10.1053/euje.2000.0012.

DOI:10.1053/euje.2000.0012

PMID:12086210

Abstract

AIMS

To evaluate the impact of second harmonic (SH) compared to fundamental mode (FM) imaging on the echocardiographic determination of ejection fraction (EF) and wall motion score index (WMSI), using MIBI gated SPECT as an independent reference.

METHODS

Sixty-two consecutive patients underwent an echocardiography study and a MIBI gated SPECT over 24 hours. EF was estimated visually (estimated-E) and was calculated with the Simpson biplane method (Tracing-T), for both FM and SH. WMSI was determined by two independent echo-readers blinded to the nuclear imaging results. The same segmentation and scoring system was used for WMSI determined by MIBI gated SPECT.

RESULTS

The percentages of unscored segments because of suboptimal endocardial border detection were 19.5% (FM) and 9.0% (SH). The correlation coefficients (r) between SPECT-EF and echo-EF were: FM (E)=0.705, FM (T)=0.546, SH (E)=0.771, SH (T)=0.743. Agreement between SPECT-EF and echo-EF was acceptable for both imaging modalities (mean of the difference +/- 2 S.D.): -2.8 +/- 18.5 (FM) and -3.5 +/- 16.4 (SH). Correlation coefficients (r) between WMSI calculated by SPECT and by echo were 0.715 (FM) and 0.789 (SH). Agreement between SPECT-WMSI and echo-WMSI was good for all imaging modes but better with SH compared to FM: 0.12 +/- 0.91 (FM), 0.10 +/- 0.77 (SH). The interobserver correlation coefficients (r) for the WMSI were 0.939 (FM) and 0.996 (SH). The agreement between the two observers was better for SH compared to FM. The systematic differences (mean differences) were 0.21 (FM) and -0.01 (SH), and the random differences between both observers (2 S.D.) decreased from 1.55 (FM) to 0.29 (SH).

CONCLUSIONS

The use of SH echocardiography decreases the number of unscored segments. This results in an important gain in correlation and agreement for EF determination between echo and SPECT, and in a considerable decline of the interobserver variability for the echo-determined WMSI. WMSI determined by MIBI gated SPECT correlated closely with the SH WMSI, and agreement between both methods was excellent.

摘要

目的

以心肌灌注显像（MIBI）门控单光子发射计算机断层扫描（SPECT）作为独立参考标准，评估与基波模式（FM）成像相比，二次谐波（SH）成像对超声心动图测定射血分数（EF）和室壁运动评分指数（WMSI）的影响。

方法

62例连续患者在24小时内接受了超声心动图检查和MIBI门控SPECT检查。对FM和SH图像，均采用视觉估计（estimated-E）和Simpson双平面法计算（Tracing-T）EF。WMSI由两名对核成像结果不知情的独立超声心动图阅片者确定。MIBI门控SPECT确定WMSI时采用相同的节段划分和评分系统。

结果

因心内膜边界检测不佳而未评分节段的百分比，FM为19.5%，SH为9.0%。SPECT-EF与超声心动图-EF之间的相关系数（r）分别为：FM（E）=0.705，FM（T）=0.546，SH（E）=0.771，SH（T）=0.743。两种成像方式下SPECT-EF与超声心动图-EF之间的一致性均可接受（差值均值±2标准差）：-2.8±18.5（FM）和-3.5±16.4（SH）。SPECT计算的WMSI与超声心动图计算的WMSI之间的相关系数（r）分别为0.715（FM）和0.789（SH）。SPECT-WMSI与超声心动图-WMSI之间的一致性在所有成像模式下均良好，但SH模式优于FM模式：0.12±0.91（FM），0.10±0.77（SH）。WMSI的观察者间相关系数（r）分别为0.939（FM）和0.996（SH）。与FM相比，SH模式下两名观察者之间的一致性更好。系统差异（均值差异）分别为0.21（FM）和-0.01（SH），两名观察者之间的随机差异（2标准差）从1.55（FM）降至0.29（SH）。