超声心动图联合CT血管造影成像诊断心脏二尖瓣脱垂的临床价值
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摘要
目的探究超声心动图(UCG)联合CT血管造影(CTA)应用于二尖瓣脱垂(MVP)诊断的临床价值。方法回顾性分析28例MVP患者临床资料,比较UCG、CTA及手术测量病变情况差异,以手术所见为诊断"金标准",分析术前UCG、CTA及二者联合方案的诊断效能差异区别。结果 UCG、CTA、手术测量瓣环周长、瓣叶厚度水平及腱索断裂率比较均无统计学意义(P>0.05),而UCG测得瓣环位移水平明显低于手术测量,CTA测得幕状区面积水平明显低于手术测量(P<0.05)。单纯UCG及单纯CTA诊断MVP准确率均明显低于UCG联合CTA方案(P<0.05)。结论 UCG与CTA均可获得较为丰富且精确的MVP病变信息,二者联合应用可相互补充以增强诊断效能,临床应用价值较高。
Objective To explore the clinical value of ultrasonic cardiogram(UCG) combined with CT angiography(CTA) in the diagnosis of mitral valve prolapse(MVP).Methods The clinical data of 28 patients with MVP were retrospectively analyzed retrospectively. The differences of lesions condition were compared by UCG, CTA and surgical measurement. The surgical findings were used as the gold standard to analyze the diagnostic efficacy of preoperative UCG, CTA and the combination of the two. Results There were no significant differences in the annulus circumference, valve leaflet thickness and choraetendinae rupture rate by UCG, CTA and surgical measurement(P>0.05), and the annulus displacement level measured by UCG was significantly lower than that by surgical measurement, and the area of tentorial region measured by CTA was significantly lower than that by surgical measurement(P<0.05). The accuracy rate by simple UCG and simple CTA was significantly lower than that by UCG combined with CTA in the diagnosis of MVP(P<0.05). Conclusion Both UCG and CTA can obtain rich and accurate MVP lesion information. The combination of these two methods helps to improve the diagnostic accuracy of the diseaseThe combination of the two can complement each other to enhance the diagnostic efficacy, and it has high clinical application value.
Objective To explore the clinical value of ultrasonic cardiogram(UCG) combined with CT angiography(CTA) in the diagnosis of mitral valve prolapse(MVP).Methods The clinical data of 28 patients with MVP were retrospectively analyzed retrospectively. The differences of lesions condition were compared by UCG, CTA and surgical measurement. The surgical findings were used as the gold standard to analyze the diagnostic efficacy of preoperative UCG, CTA and the combination of the two. Results There were no significant differences in the annulus circumference, valve leaflet thickness and choraetendinae rupture rate by UCG, CTA and surgical measurement(P>0.05), and the annulus displacement level measured by UCG was significantly lower than that by surgical measurement, and the area of tentorial region measured by CTA was significantly lower than that by surgical measurement(P<0.05). The accuracy rate by simple UCG and simple CTA was significantly lower than that by UCG combined with CTA in the diagnosis of MVP(P<0.05). Conclusion Both UCG and CTA can obtain rich and accurate MVP lesion information. The combination of these two methods helps to improve the diagnostic accuracy of the diseaseThe combination of the two can complement each other to enhance the diagnostic efficacy, and it has high clinical application value.
引文
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[10]宋迪,毛庆聪,毛定飚,等.二尖瓣脱垂的CT表现[J].医学影像学杂志,2014,24(2):213-214.
[11]Koo H J,Yang D H,Oh S Y,et al.Demonstration of mitral valve prolapse with CT for planning of mitral valve repair[J].Radiographics,2014,34(6):1537-1552.
[2]Basso C,Perazzolo M M,Rizzo S,et al.Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death[J].Circulation,2015,132(7):556.
[3]苏茂龙,黄小川,黄晓阳,等.经胸与经食管超声心动图在二尖瓣脱垂亚区分区中的应用研究[J].柳州医学,2013,26(4):197-201.
[4]周文辉,熊志,柯岩,等.基于冠状动脉CTA定量计算与心肌缺血临床表现的相关性分析[J].中国CT和MRI杂志,2018,16(10):49-51.
[5]张海波,孟旭.2017年欧洲瓣膜指南与2017年美国瓣膜指南的对比性解读[J].中华胸心血管外科杂志,2018,34(2):92-95.
[6]高德宏,贾飞鸽,汪春荣,等.正常主动脉瓣及二尖瓣双源C T表现及测量[J].中国C T和M R I杂志,2013,11(3):67-69.
[7]李岳环,张海波,孟旭,等.经食管三维超声量化分析风湿性瓣膜病及退行性病变致二尖瓣结构变化的特点[J].中华胸心血管外科杂志,2017,33(8):462-465,471.
[8]高茜,成官迅,朱熠,等.双源C T诊断二尖瓣脱垂的临床应用价值探讨[J].临床放射学杂志,2014,33(9):1335-1338.
[9]Nishimura R A,Carabello B A,Faxon D P,et al.ACC/AHA 2008Guideline Update on Valvular Heart Disease:Focused Update on Infective Endocarditis[J].Journal of the American College of Cardiology,2008,52(8):676-685.
[10]宋迪,毛庆聪,毛定飚,等.二尖瓣脱垂的CT表现[J].医学影像学杂志,2014,24(2):213-214.
[11]Koo H J,Yang D H,Oh S Y,et al.Demonstration of mitral valve prolapse with CT for planning of mitral valve repair[J].Radiographics,2014,34(6):1537-1552.