双源CT评估左心室功能的准确性研究—与心超对照

发布时间：2018-11-25 12:51

【摘要】：目的：探讨第二代双源CT (dual-source CT, DSCT)评估左心室功能参数[左室射血分数(left ventricular ejection fraction,LVEF)、鐕左室舒张末期容积(end-diastolic volume, EDV)、左室收缩末期容积(end-systolic volume, ESV)、每搏输出量(stroke volume, SV)]的准确性,并与超声心动图进行对比。材料与方法：入选60例临床上可疑或确诊冠心病患者,所有患者均在72小时内采用第二代DSCT回顾性心电门控的方法进行常规冠状动脉扫描及超声心动图检查。分为两组,每组30例患者。组1为全剂量组(在心电门控非最大管电流调制情况下扫描),组2为非全剂量组(在心电门控最大管电流调制情况下扫描)。测量60例患者的DSCT和心超的EF、EDV、ESV、SV数据,评估两种检查方法的相关性,以及组1和组2之间图像质量评分。同时记录患者辐射剂量。结果：DSCT和心超所测得的LVEF、EDV、ESV、SV值有很好的相关性(组1：EFr=0.861, EDV r=0.976, ESV r=0.977, SV r=0.950;组2：EF r=0.898, EDV r=0.947, ESV r=0.963, SV r=0.917;P值均0.001)。组2的EDV图像质量评分明显低于组1(P0.001),但不影响左心室功能参数的评估,两组患者的CT心功能参数与心超结果都有很好的一致性。结果显示,除组1DSCT与心超测得的ESV值有统计学差异(P=0.038),余DSCT计算出的参数与心超结果没有统计学差异(P0.05)。患者的平均辐射剂量：组1=7.12±2.23mSv；组2=3.70±0.89mSv。结论：以心超所测得的数据为对照,DSCT可以提供可靠的LVEF、EDV、ESV、 SV测量结果。虽然组2的EDV图像质量评分要明显低于组1(P0.001),但这并不影响左室功能参数的测定,即在非全剂量情况下就可以获得可靠的心功能参数结果,这样有利于降低患者的辐射剂量。
[Abstract]:Objective: to investigate the evaluation of left ventricular function parameters (left ventricular ejection fraction (left ventricular ejection fraction,LVEF), left ventricular end-diastolic volume (end-diastolic volume, EDV),) and left ventricular end-systolic volume (end-systolic volume,) by second-generation dual-generation CT (dual-source CT, DSCT) in evaluating left ventricular function [left ventricular ejection fraction (left ventricular ejection fraction,LVEF)]. The accuracy of ESV), per beat output (stroke volume, SV) was compared with that of echocardiography. Materials and methods: 60 patients with suspected or confirmed coronary heart disease were enrolled in this study. All patients underwent routine coronary artery scanning and echocardiography within 72 hours with the second generation DSCT retrospective electrocardiogram. The patients were divided into two groups, 30 patients in each group. Group 1 was a full dose group (scanned under the condition of ECG gated non-maximum current modulation) and group 2 was a non-full dose group (scan under the condition of ECG gated maximum tube current modulation). The EF,EDV,ESV,SV data of DSCT and cardiac ultrasound were measured in 60 patients to evaluate the correlation between the two methods and the image quality score between group 1 and group 2. Radiation dose was also recorded. Results: there was a good correlation between DSCT and LVEF,EDV,ESV,SV measured by cardiac ultrasound (group 1: EFr0. 861, EDV rnr 0. 976, ESV rnr 0. 977, SV rn 0. 950, 2:EF rn 0. 898, EDV rn 0. 947, ESV rn 0. 963, SV rn 0. 917). P values were 0.001). The EDV image quality score of group 2 was significantly lower than that of group 1 (P0. 001), but it did not affect the evaluation of left ventricular function parameters. The CT cardiac function parameters of both groups were in good agreement with the results of cardiac hypertrophy. The results showed that there was statistical difference in ESV between 1DSCT and cardiac hypertrophy (P0. 038), but there was no statistical difference between the parameters calculated by DSCT and the results of cardiac hypertrophy (P0.05). The average dose of radiation: group 1: 7. 12 卤2. 23 mSv, group 2: 3. 70 卤0. 89 mSv. Conclusion: DSCT can provide reliable LVEF,EDV,ESV, SV results in comparison with the data measured by cardiac ultrasound. Although the EDV image quality score of group 2 was significantly lower than that of group 1 (P0. 001), this did not affect the measurement of left ventricular function parameters, that is, reliable results of cardiac function parameters could be obtained at a non-full dose. This helps to reduce the radiation dose of the patient.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.2;R540.45

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