MRI与超声心动图、心电图在心尖肥厚型心肌病患者诊断中的应用
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摘要
目的分析核磁共振(MRI)与超声心动图、心电图在心尖肥厚型心肌病(AHCM)患者诊断中的应用效果。方法回顾性分析我院73例疑似AHCM患者临床资料。以病史、临床表现及二维超声结果作为诊断金标准,评估MRI、超声心动图及心电图对AHCM的诊断价值。结果 73例疑似AHCM患者经金标准确诊为AHCM58例,MRI诊断正确71例(97.26%),漏诊1例(1.72%),误诊1例(6.67%),Kappa值为0.916,一致性极强;超声心动图诊断准确66例(90.41%),漏诊4例(6.90%),误诊3例(20.00%),Kappa值为0.713,一致性高度;心电图诊断准确59例(80.82%),漏诊10例(17.24%),误诊4例(26.67%),Kappa值为0.488,一致性中度。结论 MRI与超声心动图、心电图在AHCM诊断中均具有较好应用效果,但MRI具有更高诊断价值,临床应根据实际情况选择合适的检查手段,以提高AHCM的诊断准确性。
Objective To analyze the application effects of magnetic resonance imaging(MRI), echocardiography and electrocardiogram in the diagnosis of patients with apical hypertrophic cardiomyopathy(AHCM). Methods The clinical data of 73 patients suspected as AHCM in our hospital were retrospectively analyzed. The results of medical history,clinical manifestations and two-dimensional ultrasound were taken as diagnostic gold standards to evaluate the diagnostic value of MRI, echocardiography and electrocardiogram for AHCM. Results Among 73 patients suspected as AHCM, 58 cases were diagnosed as AHCM by gold standards, and there were 71 cases(97.26%) of correct diagnosis, 1 case(1.72%) of missed diagnosis and 1 case(6.67%) of misdiagnosis by MRI diagnosis,and the Kappa value was 0.916, and the consistency was extremely strong. There were66 cases(90.41%) of accurate diagnosis, 4 cases(6.90%) of missed diagnosis and 3 cases(20.00%) of misdiagnosis by echocardiography diagnosis, and the Kappa value was 0.713,and the consistency was high. There were 59 cases(80.82%) of accurate diagnosis, 10 cases(17.24%) of missed diagnosis and 4 cases(26.67%) of misdiagnosis by electrocardiogram diagnosis, and the Kappa value was 0.488, and the consistency was moderate. Conclusion MRI, echocardiography and electrocardiogram have good application effects in AHCM diagnosis, but MRI has higher diagnostic value. It is necessary to select appropriate examination methods according to the actual situation in clinical practice so as to improve the diagnostic accuracy of AHCM.
Objective To analyze the application effects of magnetic resonance imaging(MRI), echocardiography and electrocardiogram in the diagnosis of patients with apical hypertrophic cardiomyopathy(AHCM). Methods The clinical data of 73 patients suspected as AHCM in our hospital were retrospectively analyzed. The results of medical history,clinical manifestations and two-dimensional ultrasound were taken as diagnostic gold standards to evaluate the diagnostic value of MRI, echocardiography and electrocardiogram for AHCM. Results Among 73 patients suspected as AHCM, 58 cases were diagnosed as AHCM by gold standards, and there were 71 cases(97.26%) of correct diagnosis, 1 case(1.72%) of missed diagnosis and 1 case(6.67%) of misdiagnosis by MRI diagnosis,and the Kappa value was 0.916, and the consistency was extremely strong. There were66 cases(90.41%) of accurate diagnosis, 4 cases(6.90%) of missed diagnosis and 3 cases(20.00%) of misdiagnosis by echocardiography diagnosis, and the Kappa value was 0.713,and the consistency was high. There were 59 cases(80.82%) of accurate diagnosis, 10 cases(17.24%) of missed diagnosis and 4 cases(26.67%) of misdiagnosis by electrocardiogram diagnosis, and the Kappa value was 0.488, and the consistency was moderate. Conclusion MRI, echocardiography and electrocardiogram have good application effects in AHCM diagnosis, but MRI has higher diagnostic value. It is necessary to select appropriate examination methods according to the actual situation in clinical practice so as to improve the diagnostic accuracy of AHCM.
引文
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[6]闫朝武,程赛楠,李璐,等.肥厚型心肌病伴左心室心尖部室壁瘤的MR I延迟强化特征分析[J].中华放射学杂志,2017,51(5):345-349.
[7]张学强,相世峰,杨素君.心尖肥厚型心肌病病人M RI表现及心电图特点分析[J].中西医结合心脑血管病杂志,2 017,15(10):1280-1282.
[8]刘燕,孙丹丹,杨军,等.应用分层应变技术评价心尖肥厚型心肌病患者左心室心肌圆周应变[J].中国超声医学杂志,2018,34(6):508-511.
[9]孙亚文,胡永寸,郭山岭,等.心电图对肥厚型心肌病的诊断价值[J].中国循证心血管医学杂志,2017,9(12):1528-1529.
[2]马秀丽,牛昊,靳忠民.脉冲组织多普勒参数评价心尖肥厚型心肌病右心室功能[J].中国医学计算机成像杂志,2017,23(6):553-556.
[3]宋光,李方方,任卫东,等.实时三维超声心动图评价早期心尖肥厚型心肌病的左心室心肌节段收缩功能[J].中国医学影像学杂志,2016,24(10):758-761.
[4]谷长芹,刘爱荣.心电图、MRI及心脏超声在诊断心尖肥厚型心肌病中的应用[J].中国CT和MRI杂志,2018,16(5):81-83.
[5]郭亚美.早期心尖肥厚型心肌病患者的超声心动图特点研究[J].中国数字医学,2016,11(7):81-83.
[6]闫朝武,程赛楠,李璐,等.肥厚型心肌病伴左心室心尖部室壁瘤的MR I延迟强化特征分析[J].中华放射学杂志,2017,51(5):345-349.
[7]张学强,相世峰,杨素君.心尖肥厚型心肌病病人M RI表现及心电图特点分析[J].中西医结合心脑血管病杂志,2 017,15(10):1280-1282.
[8]刘燕,孙丹丹,杨军,等.应用分层应变技术评价心尖肥厚型心肌病患者左心室心肌圆周应变[J].中国超声医学杂志,2018,34(6):508-511.
[9]孙亚文,胡永寸,郭山岭,等.心电图对肥厚型心肌病的诊断价值[J].中国循证心血管医学杂志,2017,9(12):1528-1529.