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64 层多排螺旋 CT 评估风湿性二尖瓣狭窄患者右心室功能:与磁共振成像的比较。

Assessment of right ventricular function for patients with rheumatic mitral stenosis by 64-slice multi-detector row computed tomography: comparison with magnetic resonance imaging.

机构信息

Department of Radiology, Southwest Hospital, the Third Military Medical University, Shapingba, Chongqing 400038, China.

出版信息

Chin Med J (Engl). 2012 Apr;125(8):1469-74.

Abstract

BACKGROUND

Right ventricular (RV) dysfunction ensues due to rheumatic mitral stenosis (RMS). The evaluation of RV function is clinically important for the diagnosis, treatment, and follow-up for patients with different degrees of RMS. The purpose of this study was to determine whether the 64-slice multi-detector row computed tomography (64-slice MDCT) can assess the RV function in RMS with high accuracy and reproducibility when compared to MR imaging (MRI).

METHODS

Right ventricular end-diastolic and end-systolic volumes (RV-EDV and RV-ESV), stroke volume (RV-SV), ejection fraction (RV-EF), cardiac output (RV-CO), and wall mass (RV-Mass) were measured with dedicated cardiac analysis software on 64-slice MDCT and compared with values measured with MRI in 43 consecutive patients with RMS. Agreement between MRI and 64-MDCT results were compared with Bland and Altman analysis and linear regression analysis. Repeated measurements were performed to determine intraobserver and interobserver variability.

RESULTS

No significant differences were revealed in calculated RV function parameters between the two methods. RV-EDV, RV-ESV, RV-SV, RV-EF, RV-CO, and RV-Mass by 64-slice MDCT were similar to those by MRI (P > 0.05). There were good correlations (r = 0.98, 0.97, 0.96, 0.96, 0.95 and 0.77, respectively) and close agreement (bias = -0.2 ml, -1.0 ml, 0.8 ml, 0.5%, 26.1 ml, and 0.5 g, respectively, P > 0.05). The variability in 64-slice MDCT measurements was similar to that in MRI values.

CONCLUSION

ECG-gated 64-slice MDCT could assess the RV function in RMS with high accuracy and reproducibility when compared to MRI.

摘要

背景

风湿性二尖瓣狭窄(RMS)可导致右心室(RV)功能障碍。RV 功能的评估对于不同程度 RMS 患者的诊断、治疗和随访具有重要的临床意义。本研究旨在确定与 MRI 相比,64 层多排螺旋 CT(64-MDCT)能否准确、可重复地评估 RMS 中的 RV 功能。

方法

使用专用心脏分析软件在 64-MDCT 上测量 43 例连续 RMS 患者的 RV 舒张末期和收缩末期容积(RV-EDV 和 RV-ESV)、每搏量(RV-SV)、射血分数(RV-EF)、心输出量(RV-CO)和壁质量(RV-Mass),并与 MRI 测量值进行比较。采用 Bland-Altman 分析和线性回归分析比较 MRI 和 64-MDCT 结果的一致性。重复测量以确定观察者内和观察者间的变异性。

结果

两种方法计算的 RV 功能参数无显著差异。64-MDCT 的 RV-EDV、RV-ESV、RV-SV、RV-EF、RV-CO 和 RV-Mass 与 MRI 相似(P > 0.05)。两种方法具有良好的相关性(r = 0.98、0.97、0.96、0.96、0.95 和 0.77),且一致性较好(偏倚分别为-0.2 ml、-1.0 ml、0.8 ml、0.5%、26.1 ml 和 0.5 g,P > 0.05)。64-MDCT 测量的变异性与 MRI 值相似。

结论

与 MRI 相比,心电图门控 64-MDCT 可准确、可重复地评估 RMS 中的 RV 功能。

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