在不同的心脏几何学中评估左心室质量,使用三维对比增强心声学
Meiqing Zhang1, Xu Chen2, Feifei Yang3
1Department of Cardiology, Fourth Medical Center of Chinese PLA General Hospital.
International heart journal
|October 1, 2023
概括
与对比增强的3D心声学 (Contrast-3DE) 和SPECT在心肌病患者中显示一致的左心室质量 (LVM) 测量. 与标准的2D心声回声 (2DE) 相比,Contrast-3DE有效地减少了LVM的高估.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 生物医学工程 生物医学工程
背景情况:
- 精确测量左心室质量 (LVM) 对于诊断和管理心脏病状况至关重要,如多变性心肌病 (HCM) 和其他形式的左心室 (LV) 扩大.
- 传统的2D心声回声 (2DE) 方法可能会高估LVM,这可能会影响临床决策.
- 增强对比度的3D心声学 (Contrast-3DE) 和单光子发射计算机断层扫描 (SPECT) 是用于心脏评估的先进成像技术.
研究的目的:
- 为了比较2DE,对比增强2DE (对比-2DE),3DE和对比-3DE与SPECT获得的LVM测量的准确性.
- 通过心声回声学方法评估对比度增强在减少LVM高估的有效性.
- 评估不同心脏病患者的不同成像方式之间的协议,包括HCM,扩张性心肌病 (DCM) 和缺血性心肌病 (ICM).
主要方法:
- 一个69名患者的研究队列,包括23名HCM患者,26名LV扩大 (16名DCM,10名ICM) 和20名对照患者,接受了2DE,对比-2DE,3DE,对比-3DE和SPECT.
- 使用2DE-AL和3DE方法测量左心室质量 (LVM),并与SPECT参考值进行比较.
- 进行了统计分析,以评估方法之间的一致性 (r值) 和偏差,特别关注不同患者群体.
主要成果:
- 与SPECT相比,所有回声心脏学方法 (2DE-AL,对比-2DE-AL,3DE,对比-3DE) 系统地高估了LVM (P <0.05).
- 对比-3DE在LVM测量方面与SPECT达成最佳一致 (r = 0.898,P < 0.001),偏差最小 (5.7 ± 23.1 g).
- 3DE在LV缩和扩大组中显示出比Contrast-3DE更大的LVM过高估计. 在任何患者群体中,在带有和没有对比的2DE之间没有观察到LVM的显著差异.
结论:
- 相反-3DE和SPECT提供一致的LVM测量,特别是在心肌病患者中,优于标准的2DE方法.
- 对比度增强显著降低了在非对比心声回声学中观察到的LVM过高估计.
- 对比-3DE是准确的LVM评估的宝贵工具,与其他心声回声技术相比,它与SPECT有更好的协议.
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