用 320 排多层 CT 评估全球左心室功能和容积：与 2D 超声心动图的比较。

Assessment of global left ventricular function and volumes with 320-row multidetector computed tomography: A comparison with 2D-echocardiography.

机构信息

Department of Cardiology, Leiden University Medical Center, Postal Zone: C5-P, P.O. Box 9600, 2333 ZA, Leiden, The Netherlands.

出版信息

J Nucl Cardiol. 2010 Apr;17(2):225-31. doi: 10.1007/s12350-009-9173-y. Epub 2009 Dec 1.

BACKGROUND

Multidetector computed tomography (MDCT) has been demonstrated as a feasible imaging modality for noninvasive assessment of coronary artery disease and left ventricular (LV) function. Recently, 320-row systems have become available with 16 cm anatomical coverage allowing image acquisition of the entire heart within a single heartbeat. The purpose of this study was to evaluate the accuracy of 320-row MDCT in the assessment of global LV function compared to two-dimensional (2D) echocardiography as the standard of reference.

METHODS AND RESULTS

A head-to-head comparison between 320-row MDCT and 2D-echocardiography was performed in 114 patients (68 men; mean age 62 +/- 13 years) who were clinically referred for MDCT coronary angiography. The entire heart was imaged in a single heartbeat, using prospective dose modulation. LV end-diastolic volumes (LVEDV) and LV end-systolic volumes (LVESV) were determined and the LV ejection fraction (LVEF) was derived. Average LVEF was 60 +/- 10% (range 26-78%) as determined on MDCT, compared with 59 +/- 10% (range 25-77%) on 2D-echocardiography. Evaluation of LVEF by linear regression analysis showed a good correlation between MDCT and 2D-echocardiography (r(2) = .87; P < .001). Good correlations between MDCT and 2D-echocardiography were demonstrated for the assessment of LVEDV (r(2) = .91; P < .001) and LVESV (r(2) = .94; P < .001). At Bland-Altman analysis, mean differences (+/-SD) of 7.3 +/- 12.1 mL (P < .05) and 1.8 +/- 7.4 mL (P < .05) were observed between MDCT and 2D-echocardiography for LVEDV and LVESV, respectively. LVEF was slightly overestimated with MDCT (.9 +/- 3.6%; P < .05).

CONCLUSIONS

Accurate assessment of LV function and volumes is feasible with single heartbeat 320-row MDCT in patients referred for MDCT coronary angiography.

背景

多排螺旋 CT（MDCT）已被证明是一种可行的无创成像方式，可用于评估冠状动脉疾病和左心室（LV）功能。最近，320 排系统已经问世，具有 16 厘米的解剖覆盖范围，可在单次心跳内采集整个心脏的图像。本研究的目的是评估 320 排 MDCT 在评估整体 LV 功能方面的准确性，并将其与二维（2D）超声心动图作为参考标准进行比较。

方法和结果

在 114 例因 MDCT 冠状动脉造影而临床转诊的患者中进行了 320 排 MDCT 与 2D 超声心动图的头对头比较（68 名男性；平均年龄 62 +/- 13 岁）。使用前瞻性剂量调制，在单次心跳内对整个心脏进行成像。确定 LV 舒张末期容积（LVEDV）和 LV 收缩末期容积（LVESV），并得出 LV 射血分数（LVEF）。MDCT 确定的平均 LVEF 为 60 +/- 10%（范围 26-78%），2D 超声心动图为 59 +/- 10%（范围 25-77%）。通过线性回归分析评估 LVEF 显示 MDCT 与 2D 超声心动图之间具有良好的相关性（r(2) =.87；P <.001）。MDCT 与 2D 超声心动图在评估 LVEDV（r(2) =.91；P <.001）和 LVESV（r(2) =.94；P <.001）方面显示出良好的相关性。在 Bland-Altman 分析中，观察到 MDCT 与 2D 超声心动图之间 LVEDV 和 LVESV 的平均差异（+/-SD）分别为 7.3 +/- 12.1 mL（P <.05）和 1.8 +/- 7.4 mL（P <.05）。LVEF 略高于 MDCT（.9 +/- 3.6%；P <.05）。