128层CT冠状动脉成像对左心室功能的评价

目的:应用冠状动脉成像原始数据,了解左心室形态变化,评价整体左心室功能。方法:收集90例患者冠状动脉成像原始数据,行MPR,观察左心室形态和各心肌节段的变化,并应用心功能分析软件自动计算出左心室收缩末期容积(ESV)、舒张末期容积(EDV)和射血分数(EF)。根据冠状动脉、左心室形态及整体左心室功能,将所有患者分为对照组、冠心病组、左心室肥厚组及心功能衰竭组,结合各组左心室形态变化,将左心室ESV、EDV和EF进行统计学比较和分析。结果:对照组患者冠状动脉和左心室形态正常;冠心病组左心室壁局限性增厚7例和变薄13例;左心室肥厚组左心室缩小、心室壁增厚;心功能衰竭组心室扩大、室壁普遍变薄。对照组、冠心病组、左心室肥厚组、心功能衰竭组平均EDV和ESV分别为(133.58±14.91)mL、(51.33±11.06)mL;(130.68±11.53)mL、(56.16±8.24)mL;(97.59±8.18)mL、(29.53±4.78)mL;(229.40±50.64)mL、(171.27±60.64)mL。冠心病组与对照组平均EDV和ESV比较,差异无统计学意义,左心室肥厚组及心功能衰竭组与对照组比较,差异均有统计学意义(P0.001)。对照组、冠心病组、左心室肥厚组、心功能衰竭组EF分别为(61.25±5.83)%、(56.37±6.79)%、(68.94±5.36)%和(26.33±8.30)%,差异均有统计学意义。结论:应用冠状动脉成像原始数据,结合冠状动脉及左心室形态改变,无创评价左心室整体功能,实用而可行,可为临床提供更多有价值的信息。

Assessment of left ventricular function with 128-slice computed tomography coronary angiography

Objective：To noninvasively assess left ventricular morphological and functional changes using computed tomography coronary angiography raw data. Methods.. 90 patients with coronary artery disease underwent MPR. The raw data were constructed to explore left ventricular morphological and myocardial segments, and value of left ventricular end-systolic volume （ESV） ,end-diastolic volume （EDV）,and ejection fraction （EF） were automatically calculated. All patients were divided into control group, coronary artery disease （CAD） group, left ventricular hypertrophy （LVH） group, and heart failure （HF） group. ESV,EDV and EF in all groups were compared and analyzed statistically. Results： Mean EDV and ESV in control group were （133.58±14.91）mL and （51.33±11.06）mL,（130.68±11.53）mL and （56.16±8.24）mL in CAD group, （97.59±8.18）mL and （29.53±4.78）mLinLVH group,and （229.40±50.64）mL and （171.27±60.64）mLin HF group,respectively. There was no statistically significant difference for EDV and ESV between control and CAD group,and compared with mean EDV and ESV of control group,there were significant differences for those of LVH and HF group （P（0. 001）. Mean EF in all groups was （61.25±5.83）% ,（56.37±6.79）%,（68.94±5.36） %,and （26.33±8.30）% ,respectively,there were statistical differences for EF among groups. Conclusion：With the same raw data of computed tomography coronary angiography,global left ventricular function could be noninvasively assessed;further as a feasible approach,it is beneficial to accurately and timely providing more information for clinicians.