利用256iCT对左心室解剖结构和功能定量研究

目的应用256iCT对正常人左心室结构和功能相关指标进行定量研究,分析各指标与年龄和性别的关系。方法搜集506例行256iCT冠状动脉CTA结果正常的患者的影像资料;所有患者近6个月无心血管疾病病史。对原始图像进行多期重组,确定左心室舒张末期及收缩末期,分别对左心室舒张末期和收缩末期的室间隔厚度(septal wall thickness,SWT)、左室后壁厚度(posterior wall thickness,PWT)、左室宽径(LV inner diameter,LVID)、舒张末期容积(end-diastolic volume,EDV)、收缩末期容积(end-systolic volume,ESV)、每搏输出量(stroke volume,SV)和射血分数(ejection fraction,EF)进行测量和计算,并进行相关统计学处理。结果左心室舒张末期SWT、PWT、LVID 95%参考值范围分别为:4.4～12.1 mm,4.0～14.0 mm,28.1～60.8 mm。左心室收缩末期SWT、PWT、LVID 95%参考值分别为:6.2～15.7 mm,7.9～20.8 mm,18.1～46.3 mm。EDV、ESV、SV、EF 95%参考值范围分别为:55.9～165.7 ml,20.9～75.9 ml,25.8～98.6 ml,39.8%～78.3%。收缩期LVID和舒张期LVID值不同年龄组之间差异有统计学差异(P<0.05),并且随着年龄增长有增大趋势。收缩期SWT、舒张期SWT、收缩期PWT、舒张期PWT以及EF值有随着年龄增长而增大的趋势,同时EDV、ESV、SV值随着年龄增长有减小的趋势,但以上各指标在不同年龄组之间的差异均无统计学意义(P>0.05)。不同性别组分析显示除EF值无统计学差异以外,其余各指标均有统计学差异(P<0.05),且男性组各参数均大于女性组。结论初步制定了左心室形态、功能相关参数的正常参考值,为临床诊断、危险评级及预后判断提供有意义信息。

Quantitative Study of Left Ventricular Anatomic Structure and Function By 256iCT

Objective To assess reference values for the normal left ventricle anatomic structure and function with 256iCT,and confirm the relationships between those indicators and age and sex.Methods 506 patients with normal 256iCT coronary artery CTA results were collected.The image data were reconstructed and left ventricular end systole and end diastole were confirmed.Septal wall thickness(SWT),posterior wall thickness(PWT),left ventricular inner diameter(LVID),end diastolic volume(EDV),end systolic volume(ESV),stroke volume(SV),ejection fraction(EF) were analyzed statistically.Results The 95% reference ranges of SWT,PWT,LVID in left ventricular end diastole was 4.4~12.1mm,4.0~14.0mm,28.1~60.8mm,respectively,while 6.2~15.7 mm,7.9~20.8 mm,18.1~46.3 mm in left ventricular end systole.The 95% reference range of EDV,ESV,SV,EF was 55.9~165.7 ml,20.9~75.9 ml,25.8~98.6 ml,39.8%~78.3%,respectively.There was significant difference among age groups in LVID(P<0.05),which in left ventricular end diastole or end systole had the increased tendency with age increased.SWT,PWT in left ventricular end diastole or end systole and EF had the increased tendency with age increased,while EDV,ESV and SV had decreased tendency with age increased,but all of the above parameters had no significant difference among age groups(P<0.05).Except for EF,there were significant difference between males and females in all parameters(P<0.05),and the parameters value of male group were higher than those of the female group.Conclusion This study primarily establish normal reference parameters of the left atrial structure and function,and provide meaningful information for clinical diagnosis,risk rating and prognosis.