背向散射积分超声组织定征对风湿性二尖瓣病变程度判断的对比研究

目的　探讨背向散射积分 (IBS)超声组织定征判断风湿性二尖瓣病变程度的临床应用价值。方法　应用HP SONOS 2 5 0 0LE型超声诊断仪检测 3 2例二尖瓣机械瓣置换术患者和 3 0例正常人二尖瓣IBS及与主动脉后壁 (AOPW )和心包 (PC)标化值 ,以背向散射积分百分比 ( %IBS)表示 ,并与X线照片及病理结果进行对比。结果　异常组二尖瓣前叶瓣尖 (AMV )IBS[( 2 6.1± 6.1)dB]和与AOPW及PC的%IBS[( 91.6± 2 1.5 ) % ,( 68.9± 2 3 .6) % ]均高于正常对照组 [( 14 .7± 3 .9)dB ,( 5 8.6± 18.6) % ,( 3 9.3±10 .7) % ] ;钙化区IBS[( 4 0 .8± 4.5 )dB]和 %IBS[( 15 1.5± 2 8.5 ) % ,( 112 .3± 13 .6) % ]明显高于异常组 (P<0 .0 0 1)。结论　IBS对反映风湿性二尖瓣病变程度有一定的意义 ,尤其对钙化的判断有较高的敏感性。当IBS值 >3 6dB ,%IBS >12 0 % (AMV/AOPW )及 >95 % (AMV/PC)应考虑为瓣叶钙化。其敏感性为96.4% ,92 .9%和 10 0 % ,特异性为 93 .8% ,93 .8%和 90 .6%。

A comparative study in determination of the degree of rheumatic mitral valve abnormality with integrated backscatter tissue characterization

Objective To evaluate the clinical application of integrated backscatter(IBS)tissue characterization in assessing the degree of rheumatic mitral valve lesion.Methods INK of 32 patients whO accepted mitral replacement with mechanic valves and 30 normal control subjects were analyzed with HP SONOS 2500 LE ultrasonographer.IBS of mitral valves were measured and standardized by the IBS of aortic posterior wall(AMV/AOPW)or of pericardium(AMV/PC),and expressed as%IBS.It Was compared with X-rav and pathological examination.Results IBS[(26.1±6.1)dB],%IBS of AMV/AOPW[(91.6±21.5)%] and%IBS ofAMV/PCI(68.9±23.6)%]of mitral vMves tips in abnormal group were all higher than those in normal group[(14.7±3.9)dB,(58.6±18.6)%,(39.3±10.7)%];furthermore,IBS and%IBSin calcificated regions[(40.8±4.5)dB,(151.5±28.5)%,(112.3±13.6)%]were signifcantly higher than those in abnormal group.Localization of calcification by 2DE and INK accorded with the results by X-ray examination. Conclusions INK are useful in assessing the degree of rheumatic mitral valVes lesion,especially in detection of calcification.It is considered as calcification of valvewhen IBS,%IBS of AMV/AOPW and%IBS of AMV/PC is respectively more than 36 dB,120%and 95%.Their sensitivities were 96.4%,92.9%and 100%,respectively,and their specificities were 93.8%,93.8%and 90.6%,respectively.