摘要
目的研究实时三维超声心动图(RT-3DE)与磁共振(MRI)诊断肺动脉栓塞及评估右室结构和功能的临床应用价值。方法选取2017年3月至2019年3月收治的疑似肺动脉栓塞患者83例为研究对象,均进行RT-3DE、MRI检查,并以病理检查结果为金标准,分析两种检查方法诊断肺动脉栓塞的检出率、诊断效能。比较RT-3DE、MRI所测得的右心房横径(RAD)、右心室横径(RVD)、右心室游离壁厚度(RV-FW)、射血分数(EF)、每搏输出量(SV)、右心室收缩末期容积(ESV)、右心室舒张末期容积(EDV)、峰值充盈率(PFR)等参数,分析2种检查方法的一致性。结果病理结果显示,83例疑似肺动脉栓塞患者中有70例确诊为肺动脉栓塞,阳性检出率为84.34%。RT-3DE诊断肺动脉栓塞62例,阳性检出率为74.70%。MRI诊断肺动脉栓塞65例,阳性检出率为78.31%。RT-3DE、MRI诊断肺动脉栓塞阳性检出率比较差异无统计学意义(P>0.05)。与病理检查结果比较,RT-3DE诊断肺动脉栓塞的灵敏度、特异度、准确度分别为88.57%(62/70)、76.92%(10/13)、86.75%(72/83),MRI诊断肺动脉栓塞的灵敏度、特异度、准确度分别为100%(70/70)、100%(13/13)、100%(83/83),MRI诊断肺动脉栓塞的灵敏度、特异度、准确度均高于RT-3DE,差异有统计学意义(P<0.05)。RT-3DE、MRI测定右室RAD、RVD、RV-FW、EF、SV、ESV、EDV、PFR比较,差异无统计学意义(P>0.05)。Pearson相关性分析表明RT-3DE、MRI测得的右室RAD、RVD、RV-FW、EF、SV、ESV、EDV、PFR值均呈正相关性(r=0.78、0.82、0.81、0.81、0.79、0.85、0.83、0.82)。结论对于肺动脉栓塞患者,MRI技术诊断效能优于RT-3DE。RT-3DE、MRI均能准确评估右室容积和功能变化,一致性较高,具有良好的应用前景。
Objective To investigate the clinical application value of real time three dimensional echocardiography(RT 3DE)and magnetic resonance imaging(MRI)in diagnosis of pulmonary embolism and the assessment of right ventricular structure and function.Methods A total of 83 patients with suspected pulmonary artery embolism who were admitted and treated in our hospital from March 2017 to March 2019 were enrolled in the study.All the patients underwent RT 3DE and MRI examination.Taking the results of pathological examination as golden standard,the detection rates and diagnostic efficiency of the two examination methods in diagnosis of pulmonary artery embolism were analyzed and compared.The parameters including right atrial transverse diameter(RAD),right ventricular transverse diameter(RVD),right ventricular free wall thickness(RV FW),right ventricular ejection fractions(EF),stroke volume(SV),right ventricular end systolic volume(ESV),right ventricular end diastolic volume(EDV)and peak filling rate(PFR)detected by RT 3DE and MRI were observed and compared.Moreover the consistency of two detection methods was analysed.Results The pathological results showed that 70 patients were definitely diagnosed as pulmonary artery embolism among the 83 patients with suspected pulmonary artery embolism,with positive detection rate being 84.34%.And 62 patients were definitely diagnosed as pulmonary artery embolism by RT 3DE,with positive detection rate being 74.70%,and 65 patients were definitely diagnosed as pulmonary artery embolism by MRI.with positive detection rate being 78.31%.There was no significant difference in the positive detection rate between RT 3DE and MRI(P>0.05).The sensitivity,specificity and accuracy of RT 3DE in detecting pulmonary artery embolism were 88.57%(62/70),76.92%(10/13),86.75%(72/83),respectively.However the sensitivity,specificity and accuracy of MRI in detecting pulmonary artery embolism were 100%(70/70),100%(13/13),100%(83/83),respectively.which by MRI were significantly higher than those by RT 3DE(P<0.05).There were no significant differences in RAD,RVD,RV FW,EF,SV,ESV,EDV and PFR between the two examination methods(P>0.05).The pearson correlation analysis showed thatthe right ventriclar RAD,RVD,RV FW,EF,SV,ESV,EDV,PFR measured by RT 3DE were positivelycorrelated with those by MRI.Conclusion Thediagnostic efficiency of MRI for patients with pulmonaryartery embolism is superior to that of RT 3DE.Both RT 3DE and MRI can accurately assess the changes of right heart volume and function in patients with pulmonary embolism,which has better application prospect.
作者
翟江
陈海峰
李晓东
黄玉萍
戴学宇
马莉
罗泽琴
ZHAI Jiang;CHEN Haifeng;LI Xiaodong(The Second Hospital Affiliated to Hebei North College,Hebei,Zhangjiakou 075100,China)
出处
《河北医药》
CAS
2020年第4期587-590,共4页
Hebei Medical Journal
基金
张家口市科技攻关计划项目(编号:1621044D)
关键词
肺动脉栓塞
实时三维超声心动图
磁共振
pulmonary embolism
real time three dimensional echocardiography
magnetic resonance
