摘要
目的:探讨超声心动图联合CT血管造影预测非瓣膜性心房颤动患者左心耳血栓形成的价值。方法:收集2017年1月—2020年1月于我院进行左心耳血栓形成情况检查的100例非瓣膜性心房颤动患者的临床资料。对比超声心动图、CT血管造影以及二者联合分别与经食道超声心动图(TEE)诊断左心耳血栓阳性和阴性结果,分析3种方法预测非瓣膜性心房颤动患者左心耳血栓形成的价值。结果:TEE诊断左心耳血栓阳性患者33例(33.00%)、阴性患者67例(67.00%)。两类患者的基线特征对比发现,年龄65岁、有阵发性心房颤动或心力衰竭或肾功能不全的患者比例以及BMI、纤维蛋白原、D-二聚体、血清尿酸、NT-proBNP间的差异均具有统计学意义(P<0.05)。与TEE诊断结果相比,超声心动图和CT血管造影的阳性检出率分别为20.00%和47.00%,差异均具有统计学意义(P<0.05);而二者联合的阳性检出率为31.00%,差异无统计学意义(P>0.05)。超声心动图诊断TEE检查阳性与阴性患者的左心房前后径、左心房横径、左心房上下径以及左心室射血分数水平的差异均具有统计学意义(P<0.05);CT血管造影诊断TEE检查阳性与阴性患者的左心耳开口长径及短径、左心耳开口面积、左心耳容积最大值及最小值、左心耳射血分数水平的差异均具有统计学意义(P<0.05)。超声心动图、CT血管造影以及二者联合诊断的ROC曲线下面积分别为0.788、0.795和0.816。结论:比较3种方法与TEE的诊断结果,对比TEE检查阳性与阴性患者超声心动图和CT血管造影参数,可以看出二者联合的诊断效果更好、更准确,诊断价值更高。
Objective:To explore the value of echocardiography combined with CT angiography in predicting left atrial appendage thrombosis in patients with nonvalvular atrial fibrillation.Methods:The clinical data of 100 patients with non-valvular atrial fibrillation who underwent examination of left atrial appendage thrombosis in our hospital from January 2017 to January 2020 were collected.Through echocardiography,CT angiography imaging and the combination of the two,the positive and negative results of TEE diagnosis of left atrial appendage thrombosis were compared,and the value of the three methods in predicting left atrial appendage thrombosis in patients was analyzed.Results:TEE diagnosed 33 patients(33.00%)with positive left atrial appendage thrombosis and 67 patients(67.00%)without.Comparison of baseline characteristics of the two types of patients showed that the proportion of patients with age 65 years,with paroxysmal atrial fibrillation,heart failure,renal insufficiency,and the differences in BMI,fibrinogen,D2 polymer,serum uric acid,and NT-proBNP were statistically significant(P<0.05).Compared with the diagnosis results of TEE,the positive rates of echocardiography and CT angiography were 20.00%and 47.00%,respectively,and the differences were statistically significant(P<0.05);The positive detection rate of the combination of the two methods was 31.00%,and the difference was not statistically significant(P>0.05).There were statistically significant differences in the levels of left atrial anteroposterior diameter,left atrial transverse diameter,left atrial diameter,and left ventricular ejection fraction in patients with positive and negative TEE diagnosed by echocardiography(P<0.05);There were statistically significant differences in the left atrial appendage opening long and short diameters,the left atrial appendage opening area,the maximum and minimum left atrial appendage volume,and the left atrial appendage ejection fraction in the patients with positive and negative TEE diagnosis by CT angiography(P<0.05).The
作者
冉兵
常永莉
齐婧
钟伟
郑刚
孟临侠
RAN Bing;CHANG Yong-li;QI Jing;ZHONG Wei;ZHENG Gang;MENG Lin-xia(Department of Ultrasound,the Second,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xicuiyang Shaanxi 712000,China;Department of Ultrasound,Baoji Hospital of Traditional Chinese Medicine,Baoji Shaanxi 721000,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2022年第4期258-262,共5页
Journal of China Clinic Medical Imaging
基金
2020年陕西中医药大学第二附属医院学科创新团队(项目编号:2020XKTD-B03)
2020年度校级科研课题项目(项目编号:2020XK07)。
