Truszkiewicz Krystian, Macek Piotr, Poręba Małgorzata, Poręba Rafał, Gać Paweł
Center for Diagnostic Imaging, University Clinical Hospital in Wroclaw, Wroclaw, Poland.
Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland.
Radiol Res Pract. 2022 Jun 15;2022:4931945. doi: 10.1155/2022/4931945. eCollection 2022.
The aim of the study was to verify the usefulness of the radiological cardiothoracic ratio as a potential marker of left ventricular hypertrophy assessed by echocardiography. The study included 96 patients (mean age: 49.52 ± 9.64 years). Chest radiograph in the PA projection and echocardiography were performed. In CR the measurement of the cardiothoracic ratio (CTR) was performed. Assuming CTR > 0.50, heart silhouette enlargement was diagnosed. In echocardiography, four types of left ventricular geometry were assessed: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). It was shown that patients with an enlarged heart silhouette were characterized by a significantly more frequent occurrence of left ventricular hypertrophy (LVH) on echocardiography than patients with a nonenlarged heart silhouette. In the subgroup of patients with LVH compared to the subgroup of patients with normal left ventricular geometry, CTR values are statistically significantly higher, and heart silhouette enlargement is significantly more frequent. The criterion "CTR > 0.49" estimates LVH with a sensitivity of 93.3% and specificity of 82.7%, which translates into a high accuracy of 84.4%. By analyzing the prediction of left ventricular geometry types, high accuracy of CH prediction was obtained using the "CTR > 0.49" criterion of 80.2% (with a high sensitivity of 84.0% and a satisfactory specificity of 60.0%) and a high accuracy of EH prediction using the "CTR > 0.52" criterion of 71.9% (with high sensitivity 80.5% and low specificity 36.8%), as well as low CR prediction accuracy of only 57.3% (with low sensitivity 36.7%, even if high specificity 78.7%). In summary, the radiological cardiothoracic ratio may be a moderate marker of left ventricular hypertrophy assessed according to standard echocardiographic criteria, provided that its cut-off point is standardized in each population of subjects.
该研究的目的是验证放射学心胸比率作为通过超声心动图评估左心室肥厚的潜在标志物的有效性。该研究纳入了96例患者（平均年龄：49.52±9.64岁）。进行了后前位胸部X线片和超声心动图检查。在胸部X线片上测量心胸比率（CTR）。假设CTR>0.50，则诊断为心脏轮廓增大。在超声心动图中，评估了四种类型的左心室几何形态：正常几何形态（NG）、向心性重构（CR）、向心性肥厚（CH）和离心性肥厚（EH）。结果显示，与心脏轮廓未增大的患者相比，心脏轮廓增大的患者在超声心动图上左心室肥厚（LVH）的发生率明显更高。在LVH患者亚组与左心室几何形态正常的患者亚组相比，CTR值在统计学上显著更高，且心脏轮廓增大的情况明显更频繁。“CTR>0.49”这一标准估计LVH的敏感性为93.3%，特异性为82.7%，转化为84.4%的高准确率。通过分析左心室几何形态类型的预测情况，使用“CTR>0.49”标准预测CH的准确率较高，为80.2%（敏感性高，为84.0%，特异性令人满意，为60.0%），使用“CTR>0.52”标准预测EH的准确率较高，为71.9%（敏感性高，为80.5%，特异性低，为36.8%），而预测CR的准确率较低，仅为57.3%（敏感性低，为36.7%，即使特异性高，为78.7%）。总之，放射学心胸比率可能是根据标准超声心动图标准评估左心室肥厚的一个中等标志物，前提是在每个研究对象群体中对其截断点进行标准化。
