摘要
目的对比分析二维斑点追踪(2D-STI)技术与心脏MRI在评估肺动脉高压(PH)患者右心功能中的价值。方法选取我院经右心导管确诊且资料完整的77例PH患者(PH组)和77例健康志愿者(对照组),使用2D-STI测量两组右室游离壁纵向应变(RVLSrw)、右房储备功能(RASr)、右房管道功能(RASc)和右房泵功能(RASp),使用心脏MRI检测右室射血分数(RVEF)、舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、每搏输出量指数(SVI)、心指数(CI)、心肌质量(MM)及心肌质量指数(MMI);分析心脏MRI指标与2D-STI指标之间的相关性;绘制受试者工作特征(ROC)曲线分析不同指标评估PH患者右心功能的诊断效能。结果①心脏MRI检查显示,PH组RVEF、EDVI、ESVI与对照组比较差异均有统计学意义(均P<0.05);②2D-STI检查显示,PH组RVLSrw、RASr、RASc与对照组比较差异均有统计学意义(均P<0.05);③相关性分析显示,RVEF、ESVI与RVLSrw、RASr、RASc均呈正相关(均P<0.05),EDVI与RVLSrw、RASr均呈正相关(均P<0.05);④ROC曲线分析显示,RVEF、EDVI、ESVI、RVLSrw、RASr、RASc评估PH患者右心功能的曲线下面积分别为0.756、0.739、0.820、0.725、0.957、0.659,敏感性分别为49.4%、48.1%、66.2%、92.2%、92.2%、100%,特异性分别为100%、100%、100%、49.4%、88.3%、33.8%。结论2D-STI技术较心脏MRI能更准确地评估PH患者右心功能,可为临床治疗提供参考依据。
Objective To comparatively analyze the value of two-dimensional speckle tracking imaging(2D-STI)and cardiac MRI in the evaluation of right heart function in patients with pulmonary hypertension(PH).Methods The clinical data of 77 patients with PH diagnosed by right heart catheterization were retrospectively analyzed,and 77 healthy volunteers were selected as the control group.The longitudinal strain of the right ventricular free wall(RVLSrw),right atrial reserve function(RASr),right atrial duct function(RASc)and right atrial pump function(RASp)were measured by 2D-STI.The right ventricular ejection fraction(RVEF),end diastolic volume index(EDVI),end systolic volume index(ESVI),stroke volume index(SVI),heart index(CI),myocardial mass(MM),myocardial mass index(MMI)were measured by cardiac MRI.The correlation between parameters of 2D-STI and cardiac MRI were analyzed,and ROC curve was drawn to evaluate its diagnostic efficacy.Results①Cardiac MRI showed that there were statistically significant differences in RVEF,EDVI,and ESVI between the two groups(all P<0.05).②2D-STI showed that there were statistically significant differences in RVLSrw,RASr,and RASc between the two groups(all P<0.05).③Correlation analysis showed that RVEF,ESVI were positively correlated with RVLSrw,RASr,and RASc(all P<0.05),and EDVI was positively correlated with RVLSrw,RASr(both P<0.05);④ROC curve analysis showed that the area under the curve of RVEF,EDVI,ESVI,RVLSrw,RASr,and RASc for evaluating right heart function in PH patients were 0.756,0.739,0.820,0.725,0.957,0.659,respectively,and the sensitivities were 49.4%,48.1%,66.2%,92.2%,92.2%,100%,respectively,the specificities were 100%,100%,100%,49.4%,88.3%,33.8%,respectively.Conclusion Compared with cardiac MRI,2D-STI can more acurately evaluate the right heart fumtion in patients with PH,which can provide reference for clinical treatment.
作者
戴欣
刘晓莹
王惠秋
张文
魏淼
DAI Xin;LIU Xiaoying;WANG Huiqiu;ZHANG Wen;WEI Miao(Department of Medical Imaging,Chongqing Public Health Medical Center,Chongqing 400036,China)
出处
《临床超声医学杂志》
CSCD
2021年第6期427-431,共5页
Journal of Clinical Ultrasound in Medicine
关键词
斑点追踪
二维
心脏MRI
肺动脉高压
Speckle tracking imaging,two-dimensional
Cardiac MRI
Pulmonary hypertension
