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经胸超声心动图和冠状动脉CT血管造影在诊断二尖瓣脱垂中的应用。

Application of trans-thoracic echocardiography and coronary CT angiography to diagnose mitral valve prolapse.

作者信息

Li Jingbo, Zhang Yun, Zhang Liulong, Lv Deyong, Song Hui, Zhang Haifeng, Zhou Guangyan, Li Hong

机构信息

Department of Ultrasound, Dongying People's Hospital of Shandong, Dongying, 257091, China.

Department of Radiology, Dongying People's Hospital of Shandong, No. 317, Nan Yi Road, Dongying, 257091, Shandong, China.

出版信息

J Cardiothorac Surg. 2019 Jun 24;14(1):115. doi: 10.1186/s13019-019-0925-8.

Abstract

OBJECTIVE

At present, multi-detector cardiac CT has been widely applied in the detection of heart valve morphology and function. This study aims to compare the coronary CT angiography and trans-thoracic echocardiography for patients with mitral valve prolapse.

METHODS

CT angiography and trans-thoracic echocardiography were adopted to detect the movement range and thickness of valvula bicuspidalis. The ultrasonic parameters of CT angiography were considered as standard reference value.

RESULTS

Receiver operating characteristic (ROC) curve showed that the area of mitral valve motion amplitude under ROC curve was 95% detected by CT angiography with statistical significance (P < 0.001). Based on the intercept point on the ROC curve, the sensitivity and accuracy of mitral valve amplitude detected by CT angiography was 69.2 and 95.6%, the false positive and false negative rate was 5.2 and 32.4%, the predicted value of positive and negative was 92.9 and 76.9% and the consistency rate of motion range and leaf thickness detected by CT angiography was 83.3 and 47.5%. Trans-thoracic echocardiography showed that the thickness and motion range of mitral leaflet was (1.95 ± 0.22) mm and (1.5 ± 2.28) mm. The thickness and motion range of mitral leaflet that detected by CT was (2.00 ± 0.54) mm and (3.76 ± 2.1) mm.

CONCLUSION

The accuracy and reliability of CT angiography for patients with mitral valve prolapse are higher than those of trans-thoracic echocardiography.

摘要

目的

目前,多排探测器心脏CT已广泛应用于心脏瓣膜形态和功能的检测。本研究旨在比较二尖瓣脱垂患者的冠状动脉CT血管造影和经胸超声心动图。

方法

采用CT血管造影和经胸超声心动图检测二尖瓣的活动范围和厚度。将CT血管造影的超声参数作为标准参考值。

结果

受试者工作特征(ROC)曲线显示,CT血管造影检测到的二尖瓣运动幅度在ROC曲线下面积为95%,具有统计学意义(P < 0.001)。根据ROC曲线上的截点,CT血管造影检测二尖瓣幅度的敏感性和准确性分别为69.2%和95.6%,假阳性率和假阴性率分别为5.2%和32.4%,阳性和阴性预测值分别为92.9%和76.9%,CT血管造影检测的运动范围和瓣叶厚度的一致性率分别为83.3%和47.5%。经胸超声心动图显示二尖瓣叶的厚度和运动范围分别为(1.95±0.22)mm和(1.5±2.28)mm。CT检测的二尖瓣叶厚度和运动范围分别为(2.00±0.54)mm和(3.76±2.1)mm。

结论

二尖瓣脱垂患者CT血管造影的准确性和可靠性高于经胸超声心动图。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ff/6591803/d05968846924/13019_2019_925_Fig1_HTML.jpg

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