数字心室造影术：通过校正计算机密度测定法对冠状动脉疾病患者心脏容积进行有效的在线计算。

Digital ventriculography: valid on-line calculation of cardiac volumes by corrected computer densitometry in coronary artery disease.

作者信息

Lehmkuhl H, Blunck B, Altstidl R, Barth K, Bachmann K

机构信息

Department of Cardiology, University of Erlangen, Germany.

出版信息

Angiology. 1996 Dec;47(12):1127-37. doi: 10.1177/000331979604701202.

DOI:10.1177/000331979604701202

PMID:8956664

Abstract

Cardiac catheterization facilitates the assessment of left ventricular function in coronary artery disease (CAD). Digital left ventriculography offers the potential for an on-line quantitative determination of left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV). These are routinely evaluated by the area-length method (ALM), which is considered as a standard. Densitometry (DENS) is an alternative method but may lead to calculated underestimations. The purpose of this study was to investigate the accuracy of corrected DENS for LVEDV and LVESV in comparison with ALM in single-plane 30 degrees right anterior oblique (RAO) projection. The computer densitometric correction equation was adapted from the linear regression analysis (y = 0.86x + 2.73) in cardiac models and applied to the analysis of digital left ventriculograms in patients suffering from CAD. The study of cardiac models yielded highly significant correlations (r > or = 0.9; P < or = 0.001) between true volumes and both DENS and ALM. DENS and ALM correlated highly significantly (r > or = 0.9; P < or = 0.001) with a low standard error of estimate (SEE) of +/-9.5 mL. The comparison of DENS and ALM in 44 patients' digital ventriculograms exhibited highly significant (r = 0.74; P < or = 0.001) correlations for noncorrected and corrected LVEDV. Systematic underestimation by DENS of LVEDV disappeared after correction and SEE decreased from +/-23.7 to +/-19.2 mL. DENS and ALM correlated highly significantly for LVESV (r = 0.78; P < or = 0.001; SEE +/- 15.6 mL +/- 13.5 mL, respectively) after correction. Following correction, mean values for DENS increased from 116 +/- 32 to 132 +/- 37 mL (LVEDV) and 50 +/- 22 to 55 +/- 25 mL (LVESV). For ALM, mean values decreased from 159 +/- 35 to 127 +/- 28 mL (LVEDV) and 55 +/- 25 to 46 +/- 21 mL (LVESV). This study shows that LVEDV and LVESV can be reliably analyzed on-line by corrected computer densitometry. Method-related errors of both DENS and ALM are present and account for minor volume deviations.

摘要

心脏导管插入术有助于评估冠状动脉疾病（CAD）患者的左心室功能。数字左心室造影为在线定量测定左心室舒张末期容积（LVEDV）和左心室收缩末期容积（LVESV）提供了可能。这些通常通过面积 - 长度法（ALM）进行评估，该方法被视为标准方法。密度测定法（DENS）是一种替代方法，但可能导致计算值低估。本研究的目的是在单平面30度右前斜（RAO）投影中，将校正后的DENS用于LVEDV和LVESV的准确性与ALM进行比较。计算机密度测定校正方程源自心脏模型中的线性回归分析（y = 0.86x + 2.73），并应用于分析CAD患者的数字左心室造影图像。心脏模型研究表明，真实容积与DENS和ALM之间均具有高度显著的相关性（r≥0.9；P≤0.001）。DENS和ALM具有高度显著的相关性（r≥0.9；P≤0.001），估计标准误差（SEE）较低，为±9.5 mL。对44例患者数字心室造影图像中DENS和ALM的比较显示，未校正和校正后的LVEDV具有高度显著的相关性（r = 0.74；P≤0.001）。校正后，DENS对LVEDV的系统性低估消失，SEE从±23.7 mL降至±19.2 mL。校正后，DENS和ALM对LVESV的相关性也高度显著（r = 0.78；P≤0.001；SEE分别为±15.6 mL和±13.5 mL）。校正后，DENS的平均值从116±32 mL增加到132±37 mL（LVEDV），从50±22 mL增加到55±25 mL（LVESV）。对于ALM，平均值从159±35 mL降至127±28 mL（LVEDV），从55±25 mL降至46±21 mL（LVESV）。本研究表明，校正后的计算机密度测定法可可靠地在线分析LVEDV和LVESV。DENS和ALM均存在与方法相关的误差，且这些误差导致了较小的容积偏差。