Ghersin Eduard, Castellon Ivan, Runco Therrien Jennifer E, Tanawuttiwat Tanyanan, Lessick Jonathan, Checkver Adam, Soto Victor
Department of Radiology, Leonard M. Miller School of Medicine, University of Miami, Florida, USA.
Acute Card Care. 2013 Sep;15(3):69-75. doi: 10.3109/17482941.2013.822085.
Evaluating ECG-gated cardiac MDCT detection of systolic anterior motion of the mitral valve, in comparison to trans-thoracic echocardiography as a gold standard.
Study group included 83 consecutive patients (57 men; average age 56.1 years) evaluated with both retrospective ECG-gated cardiac MDCT and trans-thoracic echocardiography within an interval of 30 days. ECG-gated cardiac MDCT imaging was performed with retrospective ECG- gating using 64-slice and 128-slice CT scanners with an inherent temporal resolution range of 75-165 ms. MDCT's and trans- thoracic echocardiograms were retrospectively and independently evaluated by experienced radiologist and cardiologist respectively, for presence of systolic anterior motion of the mitral valve.
7 patients (8.4%) were found to have systolic anterior motion by trans-thoracic echocardiography, from which 6 were found to have systolic anterior motion by ECG-gated cardiac MDCT. Of the 76 patients without systolic anterior motion on trans-thoracic echocardiography, all were correctly identified using ECG-gated cardiac MDCT. The sensitivity, specificity, positive and negative predictive values and accuracy of ECG-gated cardiac MDCT in identifying systolic anterior motion of the mitral valve were 85.7% (6/7), 100% (76/76), 100% (6/6), 98.7% (76/77) and 98.8% (82/83), respectively.
ECG-gated cardiac MDCT is comparable to trans-thoracic echocardiography in detecting systolic anterior motion of the mitral valve.
与作为金标准的经胸超声心动图相比，评估心电图门控心脏MDCT对二尖瓣收缩期前向运动的检测能力。
研究组包括83例连续患者（57例男性；平均年龄56.1岁），在30天内先后接受回顾性心电图门控心脏MDCT和经胸超声心动图检查。使用64层和128层CT扫描仪，采用回顾性心电图门控技术进行心电图门控心脏MDCT成像，其固有时间分辨率范围为75 - 165毫秒。MDCT图像和经胸超声心动图分别由经验丰富的放射科医生和心脏病专家进行回顾性独立评估，以确定二尖瓣收缩期前向运动的存在情况。
经胸超声心动图发现7例患者（8.4%）存在二尖瓣收缩期前向运动，其中6例通过心电图门控心脏MDCT也发现有二尖瓣收缩期前向运动。在经胸超声心动图未发现二尖瓣收缩期前向运动的76例患者中，心电图门控心脏MDCT均正确识别。心电图门控心脏MDCT在识别二尖瓣收缩期前向运动方面的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为85.7%（6/7）、100%（76/76）、100%（6/6）、98.7%（76/77）和98.8%（82/83）。
心电图门控心脏MDCT在检测二尖瓣收缩期前向运动方面与经胸超声心动图相当。
