论著-头颈部
超声心动图联合CT 血管造影成像诊断 心脏二尖瓣脱垂的 临床价值*
作者:唐 浩1 黄 昊2
所属单位:1.四川省都江堰市中医医院超声科 (四川 都江堰 611830) 2.成都医学院第一附属医院放射科 (四川 成都 610500)
PDF摘要
目的 探究超声心动图(UCG)联合 CT血管造影(CTA)应用于二尖瓣脱垂(MVP) 诊断的临床价值。方法 回顾性分析28例 MVP患者临床资料,比较UCG、CTA及手术 测量病变情况差异,以手术所见为诊断 “金标准”,分析术前UCG、CTA及二者联 合方案的诊断效能差异区别。结果 UCG、 CTA、手术测量瓣环周长、瓣叶厚度水平 及腱索断裂率比较均无统计学意义(P> 0.05),而UCG测得瓣环位移水平明显低于 手术测量,CTA测得幕状区面积水平明显 低于手术测量(P<0.05)。单纯UCG及单纯 CTA诊断MVP准确率均明显低于UCG联合CTA 方案(P<0.05)。结论 UCG与CTA均可获得 较为丰富且精确的MVP病变信息,二者联 合应用可相互补充以增强诊断效能,临床 应用价值较高。
Objective To explore the clinical value of ultrasonic cardiogram (UCG) combined with CT angiography (CTA) in the diagnosis of mitral valve prolapse (MVP). Methods The clinical data of 28 patients with MVP were retrospectively analyzed retrospectively. The differences of lesions condition were compared by UCG, CTA and surgical measurement. The surgical findings were used as the gold standard to analyze the diagnostic efficacy of preoperative UCG, CTA and the combination of the two. Results There were no significant differences in the annulus circumference, valve leaflet thickness and choraetendinae rupture rate by UCG, CTA and surgical measurement (P>0.05), and the annulus displacement level measured by UCG was significantly lower than that by surgical measurement, and the area of tentorial region measured by CTA was significantly lower than that by surgical measurement (P<0.05). The accuracy rate by simple UCG and simple CTA was significantly lower than that by UCG combined with CTA in the diagnosis of MVP (P<0.05). Conclusion Both UCG and CTA can obtain rich and accurate MVP lesion information. The combination of these two methods helps to improve the diagnostic accuracy of the diseaseThe combination of the two can complement each other to enhance the diagnostic efficacy, and it has high clinical application value.
【关键词】超声心动图;CT血管造影; 二尖瓣脱垂
【中图分类号】R542;R540
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.06.022
前言
二尖瓣脱垂(MVP)属于二尖瓣关闭不全的主要原因之一,可由先天 性、退行性、感染性、功能性病变独立或共同导致[1],患者由于单个 或2个瓣叶在心动收缩期脱向左房而引起反流,可严重增加左心容量负 荷,长期可引起心功能失代偿[2],危险性较大。外科手术仍是治疗MVP 的最有效途径,因此术前通过影像学检查方法确诊并评估脱垂程度尤 为关键。超声心动图(UCG)凭借安全简便、诊断信息全面等特征,已成 为心脏疾病的最主要诊断方案,但仍对操作者经验依赖性较强、且可 重复性欠佳[3]。CT血管造影(CTA)则具备较高分辨率,已在冠状动脉病 变诊断中获得临床广泛共识[4],虽然理论上能充分显示血流腔体内病变 形态,然而在瓣膜病变领域应用则较少。对此,本研究旨在探索UCG联 合CTA对MVP的临床诊断价值,现将取得成果报道如下。
中国CT和MRI杂志
第17卷, 第 6 期
2019年06月
相关文章