延迟增强CT评估肥厚型心肌病心肌纤维化的意义

发布时间：2018-05-30 17:22

本文选题：心肌病 + 肥厚性　；参考：《中国医学影像学杂志》2015年02期

【摘要】：目的以心脏MRI作为参照标准,评估双源CT在诊断肥厚型心肌病心肌延迟强化和左心室壁厚度的诊断准确性。资料与方法选取80例经临床诊断确诊为肥厚型心肌病患者,所有患者行双源CT动脉期、延迟期扫描及心脏MRI形态和延迟增强检查。根据美国心脏病协会17节段分析方法,左心室室壁厚度、延迟强化的位置得到确认,分析2种检查诊断心肌延迟强化的相关性。结果 80例患者共1360个心肌节段进行评估,CT与MRI测量的左心室室壁平均厚度间呈显著相关(r=0.88,P0.01)。延迟增强检查证实CT与MRI在检出心肌纤维化病灶方面一致性较好(患者74例,Kappa=0.751,P0.05;心肌节段1238个节段,Kappa=0.746,P0.01)。CT与MRI测量的延迟强化病灶体积呈良好的相关性(r=0.89,P0.01),但CT图像低估纤维化病灶范围。Bland-Altman分析显示,CT和MRI在测量延迟强化病灶容积的差异,平均标准差为2.71%。结论心脏CT检查可以提供关于心肌和冠状动脉的综合信息,延迟增强CT可作为评估心肌纤维化的检查方法,是诊断肥厚型心肌病潜在的有效诊断方法。
[Abstract]:Objective to evaluate the diagnostic accuracy of dual-source CT in the diagnosis of hypertrophic cardiomyopathy with delayed enhancement of myocardium and left ventricular wall thickness. Materials and methods 80 cases of hypertrophic cardiomyopathy diagnosed by clinical diagnosis were selected. All patients were examined with dual-source CT, delayed phase CT and cardiac MRI morphology and delayed enhancement. According to the 17 segment analysis method of American Heart Association, the location of left ventricular wall thickness and delayed enhancement was confirmed, and the correlation between two kinds of examinations in diagnosing myocardial delayed enhancement was analyzed. Results there was a significant correlation between the mean left ventricular wall thickness measured by CT and MRI in 1360 myocardial segments in 80 patients. Delayed contrast-enhanced CT and MRI showed good consistency in detecting myocardial fibrosis lesions (74 cases with Kappa-0.751a P0.05; 1238 segments with 1238 segments Kappa-0.746G P0.01U. Ct and MRI) showed a good correlation with the volume of delayed enhancement lesions measured by MRI, but CT images were underestimated. Bland-Altman analysis showed that CT and MRI were different in measuring the volume of delayed enhancement lesions. The average standard deviation is 2.71%. Conclusion Cardiac CT can provide comprehensive information about myocardium and coronary artery. Delayed enhanced CT can be used to evaluate myocardial fibrosis and is a potential and effective diagnostic method for hypertrophic cardiomyopathy.
【作者单位】：首都医科大学附属北京安贞医院医学影像科;首都医科大学附属北京安贞医院干部病房;
【基金】：国家自然科学基金项目(81101173) 北京市卫生系统高层次卫生技术人才培养计划(2013-3-005)
【分类号】：R542.2;R816.2

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