MRI与64层螺旋CT在陈旧性心肌梗死左心功能评价中的应用
|
摘要
目的探讨磁共振成像(MRI)与64层螺旋CT在陈旧性心肌梗死左心功能评价中的应用。方法选择我院150例陈旧性心肌梗死患者为研究对象,均进行MRI检查和64层螺旋CT检查,均检测患者左心功能[左室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)和舒张末期心肌质量(MM)],并以MRI结果作为标准,评估64层螺旋CT检测结果信效度和一致性。结果 64层螺旋CT检查结果中EDV、ESV、SV、EF和MM与MRI结果均无显著差异(P﹥0.05),其相关性r依次为1.843、1.217、1.405、1.985和1.326,差异均有统计学意义(P﹤0.05)。以MRI检查EF﹤50%结果为标准,64层螺旋CT检测灵敏度为100%(71/71),特异度为96.20%(76/79),准确度为98.00%(147/150),阳性预测值为95.95%(71/74),阴性预测值为100%(76/76)。64层螺旋CT检查结果与MRI检查结果一致性检验(κ=1.428,P﹥0.05),差异不显著。结论 64层螺旋CT评价陈旧性心肌梗死患者左心功能灵敏度和准确度均较高,结果可靠,与MRI一致性好。
Objective To explore the application of magnetic resonance imaging(MRI) and 64-slice spiral CT in evaluation of left cardiac function in old myocardial infarction. Methods 150 cases of patients with old myocardial infarction in our hospital were selected for the study and were given MRI and 64-slice spiral CT examinations. The left cardiac function [ left ventricular end diastolic volume(EDV), end systolic volume(ESV), stroke volume(SV), ejection fraction(EF) and diastolic myocardial mass(MM)] were detected, and the MRI results were taken as the standard, the validity and consistency of detection results of 64 slice spiral CT were evaluated. Results There was no significant difference in EDV, ESV, SV, EF, MM and MRI results between 64-slice spiral CT and MRI(P>0.05), and the correlation r values were 1.843, 1.217, 1.405, 1.985 and 1.326 respectively(P<0.05). The EF<50% of MRI results was taken as the standard, and the sensitivity, specificity, accuracy, positive prediction value and negative predictive value by 64-slice spiral CT detection were 100%(71/71), 96.20%(76/79), 98.00%(147/150), 95.95%(71/74) and 100%(76/76). The consistency between 64-slice spiral CT findings and MRI findings was not significantly different(κ=1.428, P>0.05). Conclusion 64-slice spiral CT can have high sensitivity and accuracy in the evaluation of left heart function in patients with old myocardial infarction, and it can have reliable results and good consistency with MRI.
Objective To explore the application of magnetic resonance imaging(MRI) and 64-slice spiral CT in evaluation of left cardiac function in old myocardial infarction. Methods 150 cases of patients with old myocardial infarction in our hospital were selected for the study and were given MRI and 64-slice spiral CT examinations. The left cardiac function [ left ventricular end diastolic volume(EDV), end systolic volume(ESV), stroke volume(SV), ejection fraction(EF) and diastolic myocardial mass(MM)] were detected, and the MRI results were taken as the standard, the validity and consistency of detection results of 64 slice spiral CT were evaluated. Results There was no significant difference in EDV, ESV, SV, EF, MM and MRI results between 64-slice spiral CT and MRI(P>0.05), and the correlation r values were 1.843, 1.217, 1.405, 1.985 and 1.326 respectively(P<0.05). The EF<50% of MRI results was taken as the standard, and the sensitivity, specificity, accuracy, positive prediction value and negative predictive value by 64-slice spiral CT detection were 100%(71/71), 96.20%(76/79), 98.00%(147/150), 95.95%(71/74) and 100%(76/76). The consistency between 64-slice spiral CT findings and MRI findings was not significantly different(κ=1.428, P>0.05). Conclusion 64-slice spiral CT can have high sensitivity and accuracy in the evaluation of left heart function in patients with old myocardial infarction, and it can have reliable results and good consistency with MRI.
引文
[1]张春.注射地尔硫卓对陈旧性心肌梗死后心绞痛的疗效观察[J].现代预防医学,2015,42(6):1139-1140.
[2]刘津军,王绍伟,张丽娜,等.坎地沙坦联合贝那普利治疗陈旧性心肌梗死合并心力衰竭对患者血流动力学及预后的影响[J].解放军医药杂志,2016,28(6):5-7.
[3]魏红星,马圆圆,段绍峰,等.正电子发射断层扫描心肌代谢显像定量评价陈旧性心肌梗死患者左心室心肌重构程度的研究[J].中国循环杂志,2015,30(3):235-239.
[4]熊艳,苏晖,殷亮,等.比较64层螺旋CT与超声心动图对左心室功能的评价[J].中国循证心血管医学杂志,2016,8(5):530-532.
[5]黄松涛,赵嘉英,刘兰祥,等.超声与磁共振对扩张型心肌病患者心功能参数测量比较[J].中华地方病学杂志,2016,35(8):616-619.
[6]陈盔,沈比先,丁晨宇,等.MRI多技术扫描在心肌梗死后评估及预后的应用价值[J].医学综述,2017,23(7):1379-1383.
[7]何佳.高频彩色多普勒成像技术应用于小腿肌肉和肌腱损伤的诊断效果研究分析[J].华南国防医学杂志,2015,29(12):947-949.
[8]朱江,金军标,李宏斌,等.MRI与CT检查老年多发性脑梗死临床分析[J].医学影像学杂志,2015,25(8):1446-1449.
[9]祁定坤.64层MSCT冠状动脉成像中前瞻性心电门控横断面扫描技术的应用分析[J].现代中西医结合杂志,2016,25(6):662-664.
[10]黄晗,刘白鹭.64层螺旋CT评估冠脉狭窄与左心室功能的临床应用研究[J].中国CT和MRI杂志,2016,14(7):44-46.
[11]张永海,孙艳秋,白峻虎,等.高原冠心病冠状动脉病变及左心功能的CT研究[J].实用放射学杂志,2016,32(11):1749-1758.
[12]钱根年,陈自谦,付丽媛,等.多层螺旋CT图像常见伪影的影响因素与解决方案[J].中国医学装备,2017,14(5):18-22.
[2]刘津军,王绍伟,张丽娜,等.坎地沙坦联合贝那普利治疗陈旧性心肌梗死合并心力衰竭对患者血流动力学及预后的影响[J].解放军医药杂志,2016,28(6):5-7.
[3]魏红星,马圆圆,段绍峰,等.正电子发射断层扫描心肌代谢显像定量评价陈旧性心肌梗死患者左心室心肌重构程度的研究[J].中国循环杂志,2015,30(3):235-239.
[4]熊艳,苏晖,殷亮,等.比较64层螺旋CT与超声心动图对左心室功能的评价[J].中国循证心血管医学杂志,2016,8(5):530-532.
[5]黄松涛,赵嘉英,刘兰祥,等.超声与磁共振对扩张型心肌病患者心功能参数测量比较[J].中华地方病学杂志,2016,35(8):616-619.
[6]陈盔,沈比先,丁晨宇,等.MRI多技术扫描在心肌梗死后评估及预后的应用价值[J].医学综述,2017,23(7):1379-1383.
[7]何佳.高频彩色多普勒成像技术应用于小腿肌肉和肌腱损伤的诊断效果研究分析[J].华南国防医学杂志,2015,29(12):947-949.
[8]朱江,金军标,李宏斌,等.MRI与CT检查老年多发性脑梗死临床分析[J].医学影像学杂志,2015,25(8):1446-1449.
[9]祁定坤.64层MSCT冠状动脉成像中前瞻性心电门控横断面扫描技术的应用分析[J].现代中西医结合杂志,2016,25(6):662-664.
[10]黄晗,刘白鹭.64层螺旋CT评估冠脉狭窄与左心室功能的临床应用研究[J].中国CT和MRI杂志,2016,14(7):44-46.
[11]张永海,孙艳秋,白峻虎,等.高原冠心病冠状动脉病变及左心功能的CT研究[J].实用放射学杂志,2016,32(11):1749-1758.
[12]钱根年,陈自谦,付丽媛,等.多层螺旋CT图像常见伪影的影响因素与解决方案[J].中国医学装备,2017,14(5):18-22.