MRI与超声对高血压伴心室肥厚患者左心室功能的评估价值
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摘要
目的研究MRI与超声对高血压伴心室肥厚患者左心室功能的检测结果准确性并评估两种检查方法临床应用价值。方法将92例高血压患者根据左室心肌质量指数(LVMI)分为高血压组和LVH组,同时另选我院同期健康体检者50例为对照组,对3组研究对象分别进行B超和CMR检查,比较两种检查方法所测心功能指标差异并采用Bland-Altman图分析其一致性。结果 B超和MRI测量结果显示,对照组、高血压组和LVH组LVMI呈上升趋势,各组间差异有统计学意义(P<0.05),且各组B超测量结果均低于CMR,差异有统计学意义(P<0.05);B超和MRI所测高血压组PER及TPER均高于对照组,LVH组LVEDV、LVESV、SV、PER及TPER均高于对照组和高血压组,差异有统计学意义(P<0.05),且B超所测LVEDV、SV、PER低于CMR,TPER高于CMR,差异有统计学意义(P<0.05);Bland-Altman图分析结果显示,B超与CMR对左室心功能指标测量结果均值差范围较大,其中B超对LVEDV、LVESV、SV、EF及PER测量结果偏低,对TPER测量结果偏高,但两种检查方法所测LVEDV、LVESV、PER及TPER一致性较好。结论 B超对高血压伴LVH患者心功能指标检测结果准确性较MRI偏低,两种检查方法测量结果差异较大,但一致性良好。
Objective To study the detection accuracy of MRI and ultrasound on left ventricular function in patients with hypertension complicated with ventricular hypertrophy and evaluate the clinical citation value of the two methods. Methods A total of 92 cases of patients with hypertension were divided into hypertension group and LVH group according to left ventricular mass index(LVMI). At the same time, another 50 healthy examiners in our hospital were selected as control group, and the three groups were given B-ultrasound and CMR examination. The cardiac function indicators measured by the two examination methods were compared, and the consistency was analyzed by Bland-Altman diagram. Results B-ultrasound and MRI showed that the LVMI in control group, hypertension group and LVH group showed an upward trend(P<0.05), and the B-ultrasound measurement results of each group were lower than CMR(P<0.05). The PER and TPER in hypertension group measured by B-ultrasound and MRI were higher than those in control group, and the LVEDV, LVESV, SV, PER and TPER in LVH group were higher than those in control group and hypertension group(P<0.05), and the LVEDV, SV and PER measured by B-ultrasound were lower than CMR while the TPER was higher than CMR(P<0.05). Bland-Altman diagram analysis showed that the mean value difference of B-ultrasound and CMR was large in the measurement of left ventricular cardiac function indexes, and the measurement results of B-ultrasound were low on LVEDV, LVESV, SV, EF and PER while the measurement result of TPER were high, but the two methods had good consistency in LVEDV, LVESV, PER and TPER. Conclusion The accuracy of B-ultrasound in cardiac function indexes of patients with hypertension and LVH is lower than that of MRI. The measurement results of the two methods are quite different, but the consistency is good.
Objective To study the detection accuracy of MRI and ultrasound on left ventricular function in patients with hypertension complicated with ventricular hypertrophy and evaluate the clinical citation value of the two methods. Methods A total of 92 cases of patients with hypertension were divided into hypertension group and LVH group according to left ventricular mass index(LVMI). At the same time, another 50 healthy examiners in our hospital were selected as control group, and the three groups were given B-ultrasound and CMR examination. The cardiac function indicators measured by the two examination methods were compared, and the consistency was analyzed by Bland-Altman diagram. Results B-ultrasound and MRI showed that the LVMI in control group, hypertension group and LVH group showed an upward trend(P<0.05), and the B-ultrasound measurement results of each group were lower than CMR(P<0.05). The PER and TPER in hypertension group measured by B-ultrasound and MRI were higher than those in control group, and the LVEDV, LVESV, SV, PER and TPER in LVH group were higher than those in control group and hypertension group(P<0.05), and the LVEDV, SV and PER measured by B-ultrasound were lower than CMR while the TPER was higher than CMR(P<0.05). Bland-Altman diagram analysis showed that the mean value difference of B-ultrasound and CMR was large in the measurement of left ventricular cardiac function indexes, and the measurement results of B-ultrasound were low on LVEDV, LVESV, SV, EF and PER while the measurement result of TPER were high, but the two methods had good consistency in LVEDV, LVESV, PER and TPER. Conclusion The accuracy of B-ultrasound in cardiac function indexes of patients with hypertension and LVH is lower than that of MRI. The measurement results of the two methods are quite different, but the consistency is good.
引文
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[14]孙文静,孙林,赵新湘,等.3.0T心脏磁共振技术在扩张型心肌病中的临床价值[J].临床心血管病杂志,2016,32(6):595-597.
[15]牛晓琳,赵连友.炎症因子和应激因素在高血压左心室肥厚发生中的作用[J].中华高血压杂志,2014,22(6):525-527.
[2]王超,张萍.高血压左心室肥厚形成机制的研究进展[J].重庆医学,2015,44(22):3143-3146.
[3]高渊,牟建军.高血压合并左心室肥厚的危害及逆转的临床意义[J].中华高血压杂志,2016,24(10):906-909.
[4]Rautaharju PM,Soliman EZ.Electrocardiographicleft ventricular hypertrophy and the risk of adverse cardiovascular events:A critical appraisal[J].Journal of Electrocar-diology,2014,47(5):649-654.
[5]Baronerochette G,Pierard S,Seldrum S,et al.Aortic valve area,stroke volume,left ventricular hypertrophy,remodeling and fibrosis in aortic stenosis assessed by cardiac MRI[J].Circ Cardiovasc Imaging,2013,6(6):1009-1017.
[6]Biffi B,Bruse JL,Zuluaga MA,et al.Investigating Cardiac Motion Patterns Using Synthetic High-Resolution3D Cardiovascular Magnetic Resonance Images and Statistical Shape Analysis[J].Frontiers in Pediatrics,2017,5(6):34-34.
[7]中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[J].中国实用乡村医生杂志,2012,19(12):1-15.
[8]张玲玉,陈翠林,黄丽娟,等.原发性高血压合并左心室肥厚患者的胫前动脉舒张功能[J].中华高血压杂志,2014,22(04):365-370.
[9]郭杰,余灿清,吕筠,等.中国10个地区人群高血压患病率、知晓率、治疗率和控制情况分析[J].中华高血压杂志,2017,37(3):469-474.
[10]左开华.H型高血压患者冠状动脉病变诊断中冠状动脉CT技术应用的价值[J].中国CT和MRI杂志,2018,16(2):60-63.
[11]Aubdool AA,Thakore P,Argunhan F,et al.A Novelα-Calcitonin Gene-Related Peptide Analogue Protects Against End-Organ Damage in Experimental Hypertension,CardiacHypertrophy,and Heart Failure[J].Circulation,2017,136(4):367-383.
[12]Moghari MH,Komarlu R,Annese D,et al.Free-breathing steady-state free precession cine cardiac magnetic resonance with respiratory navigator gating[J].Magnetic Resonance in Medicine,2015,73(4):1555-1561.
[13]张璋,张宁男楠.心脏磁共振评价肺性高血压的临床应用与研究进展[J].天津医药,2016,44(7):921-925.
[14]孙文静,孙林,赵新湘,等.3.0T心脏磁共振技术在扩张型心肌病中的临床价值[J].临床心血管病杂志,2016,32(6):595-597.
[15]牛晓琳,赵连友.炎症因子和应激因素在高血压左心室肥厚发生中的作用[J].中华高血压杂志,2014,22(6):525-527.