摘要
目的:探讨左心腔声学造影(left ventricular opacification,LVO)评估恶性肿瘤化疗患者左室容积、射血分数(left ventricular ejection fraction,LVEF)及整体纵向应变(left ventricular global longitudinal strain,LVGLS)的可重复性研究。方法:前瞻性收集经病理证实且需抗肿瘤化疗的患者53例,根据二维心脏超声图像质量分为图像清晰组23例和图像不清晰组30例(两个及以上节段显示不清)。然后将6名不同职称资历超声医师分为高级、中级及初级3组,每组2人,均可独立完成心脏超声检查(心脏超声工作年限均≥4年),分别对患者进行心尖四腔心、二腔心、三腔心、左心长轴及左室乳头肌短轴切面图像的常规经胸超声心动图(TTE)与LVO的数据采集,用PACS系统将所有患者测量的数据进行左室容积、LVEF及LVGLS的评估。结果:3组6名超声医师分别对所有患者的图像资料进行分析,其测量参数经Kendall's W检验分析及信度分析,ICC为0.301~0.936。在图像清晰组中,左室容积、LVEF及LVGLS的一致性均较好(P<0.001)。在图像不清晰组中,对于LVEF、LVEDV及LVGLS的测量,TTE一致性较差(P>0.001),LVO测量一致性有了明显改善,但Kendall's W检验值仍偏低。对于LVESV的测量,各组及造影前后测量的一致性均较好(P<0.001)。结论:LVO能明显改善心脏超声图像不清晰的恶性肿瘤化疗患者左室容积、LVEF及LVGLS测量的准确性及可重复性,减少不同超声医师测量操作之间的差异。
Objective:To investigate a reproducible study of left ventricular volume,left ventricular ejection fraction(LVEF)and left ventricular global longitudinal strain(LVGLS)in patients with malignant tumor undergoing chemotherapy by left ventricular opacification(LVO).Methods:A total of 53 patients who were pathologically confirmed and required antitumor chemotherapy were prospectively collected.According to the quality of 2-D cardiac ultrasound images,they were divided into a clear group(23 cases)and an unclear group(30 cases)(two or more segments were unclear).Then,6 doctors with different professional titles and qualifications were divided into 3 groups:Senior,intermediate and junior,with 2 in each group.All of them could independently complete cardiac ultrasound examination(the working years of cardiac ultrasound were≥4 years).Conventional transthoracic echocardiography(TTE)and LVO data collection of apical four-chamber heart,two-chamber heart,three-chamber heart,long axis of the left heart and short axis of the left ventricular papillary muscle were performed,respectively.The PACS system was used to evaluate the left ventricular volume,LVEF and LVGLS measured by all patients.Results:The image data of all patients were analyzed by 6 doctors in 3 groups,respectively.The measured parameters were analyzed by Kendall's W test and reliability analysis,and the ICC was 0.301~0.936.The consistency of left ventricular volume,LVEF and LVGLS was better in the clear image group(P<0.001).In the unclear image group,for LVEF,LVEDV and LVGLS,TTE consistency was poor(P>0.001).LVO consistency was significantly improved,but Kendall's W test value was still low.For the measurement of LVESV,there was good agreement among all groups and before and after angiography(P<0.001).Conclusion:LVO can significantly improve the accuracy and repeatability of left ventricular volume,LVEF and LVGLS measurements in malignant tumor patients with unclear cardiac ultrasound images,and reduce the differences between different ultrasound physicians'meas
作者
李雨涵
张雪梅
李逢生
曹玲
张菲菲
赵颖
娄萍
金晶
窦水秀
赵欣
LI Yuhan;ZHANG Xuemei;LI Fengsheng;CAO Ling;ZHANG Feifei;ZHAO Ying;LOU Ping;JIN Jing;DOU Shuixiu;ZHAO Xin(Department of Ultrasound,Xi'an Gaoxin Hospital,Shaanxi Xi'an 710077,China;Ultrasound Diagnosis Center of Shaanxi Provincial People's Hospital,Shaanxi Xi'an 710068,China)
出处
《现代肿瘤医学》
CAS
2024年第18期3537-3542,共6页
Journal of Modern Oncology
基金
陕西省重点研发计划项目(编号:2019SF-191,2023-YBSF-590)
陕西省人民医院拔尖人才项目(编号:2023BJ-01)。
关键词
超声心动描记术
左心腔声学造影
肿瘤化疗
心室功能
左
可重复性
左室整体纵向应变
echocardiography
left ventricular opacification
tumor chemotherapy
ventricular function
left
repeatability of results
left ventricular global longitudinal strain
