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[多层心电图门控计算机断层扫描法:左心室容积、室壁厚度及室壁运动的评估]

[Multiserial ECG-gated computed tomographic method: Evaluation of left ventricular volumes, wall thickness and wall motion].

作者信息

Ohnishi S, Murayama A, Nagata M, Tani M, Ogawa S, Yamazaki H, Nakazawa H, Handa S, Nakamura Y

出版信息

J Cardiogr. 1983 Jun;13(2):257-64.

PMID:6676375
Abstract

The purpose of this study was to investigate the potential usefulness of multiserial ECG-gated computed tomography (CT) (GE CT/T 8800) for a quantitative assessment of left ventricular volume, wall thickness and wall motion in 15 patients with coronary heart disease. In order to obtain ideal left ventricular short-axis images, the gantry was tilted to the cephalad 15 degree with patients on the right lateral position. Five ECG-gated scans (5.6 sec for one scan) were performed in each patient with intravenous injection of contrast material (Urografin 76). Left ventricular volumes were computed by a modified Simpson's rule and segmental wall motion was analyzed at three levels (base, papillary muscle and apex) by tracing the endocardial outline at end-diastole and end-systole. Left ventricular systolic and diastolic volumes ( LVSV , LVDV ) had a good correlation with those measured by left ventriculography (LVG) (r = 0.75 and 0.66). Wall thickness of the interventricular septum and left ventricular posterior wall obtained by CT was correlated with those by M-mode echocardiography (r = 0.82 and 0.71). Comparative analysis of segmental wall motion by CT, two-dimensional (2 D) echocardiography and left ventriculography was done. The 2 D echocardiographic segments with normal and abnormal wall motion were accurately identified by CT, best at the papillary muscle level (91%), and less at the base (71%) and the apex (73%). Similarly, 85% of left ventriculographic segments could be detected by CT. In conclusion, ECG-gated computed tomography proved to be a useful method for evaluating left ventricular function in coronary heart disease.

摘要

本研究的目的是探讨多层心电图门控计算机断层扫描(CT)(GE CT/T 8800)对15例冠心病患者左心室容积、室壁厚度和室壁运动进行定量评估的潜在效用。为了获得理想的左心室短轴图像,患者取右侧卧位,扫描架向头侧倾斜15度。每位患者静脉注射造影剂(泛影葡胺76)后进行5次心电图门控扫描(每次扫描5.6秒)。左心室容积采用改良的辛普森法则计算,通过描绘舒张末期和收缩末期的心内膜轮廓,在三个层面(心底、乳头肌和心尖)分析节段性室壁运动。左心室收缩和舒张容积(LVSV、LVDV)与左心室造影(LVG)测量值具有良好的相关性(r = 0.75和0.66)。CT测得的室间隔和左心室后壁厚度与M型超声心动图测得的厚度相关(r = 0.82和0.71)。对CT、二维(2D)超声心动图和左心室造影的节段性室壁运动进行了对比分析。CT能准确识别二维超声心动图显示室壁运动正常和异常的节段,在乳头肌层面最佳(91%),在心底层面(71%)和心尖层面(73%)稍差。同样,CT能检测出85%的左心室造影节段。总之,心电图门控计算机断层扫描被证明是评估冠心病患者左心室功能的一种有用方法。

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