目的探讨超声和磁共振成像 (MRI)在诊断心肌梗死(CI)后左心室室壁 瘤(LVA)中的应用价值。方法 回顾性分 析2016年1月-2017年12月间收治的54例 疑为CI后LVA患者的临床资料，以病理检 查结果作为对照，患者均行超声心动图、 MRI和冠状动脉造影。比较超声与MRI检 测对CI后LVA的诊断应用价值，计算灵敏 度、特异度、准确率、阴性预测值和阳 性预测值。结果 ①超声心动图、MRI检 查LVA的检出率均为100%，诊断LVA分布 的准确率也均为100%，2组对比，差异无 统计学意义(P>0.05)；②MRI矛盾运动区 域检出率明显较超声心动图高(P<0.05)； ③MRI诊断CI后LVA后准确率高于超声检查 (P<0.05)。结论 超声与MRI在诊断CI后 LVA中均有其临床应用价值，应用MRI更有 利于鉴别诊断和判断LVA病情。

Objective To investigate the application value of ultrasound and magnetic resonance imaging (MRI) in the diagnosis of left ventricular aneurysm (LVA) after myocardial infarction (CI). Methods The clinical data of 54 patients with suspected LVA after CI between January 2016 and December 2017 were retrospectively analyzed. The results of pathological examination were used as controls, and the patients were given ultrasonic cardiogram, MRI and coronary angiography. The application value of ultrasound and MRI in the diagnosis of LVA after CI was compared, and the sensitivity, specificity, accuracy, negative predictive value and positive predictive value were calculated. Results The detection rates of LVA by ultrasonic cardiogram and MRI were 100%, and the accuracy rates in diagnosis of LVA distribution were also 100%, and there was no significant difference between the two groups (P>0.05). The detection rate of paradoxical movement area by MRI was significantly higher than that by ultrasonic cardiogram (P<0.05). The accuracy rate in diagnosis of LVA after CI by MRI was higher than that by ultrasound (P<0.05). Conclusion Both ultrasound and MRI have clinical application value in the diagnosis of LVA after CI. And MRI is more conducive to the differential diagnosis and judgment of LVA condition.