64层螺旋CT对左心室功能的评价

目的探讨64层螺旋CT在评价左心室功能中的应用价值。方法对35例疑诊或确诊冠心病患者同期行心脏64层螺旋CT（64SCT）、超声心动图（Echo）及X线左室造影（LVG）检查，测量射血分数（EF）、舒张末期容积（EDV）、收缩末期容积（ESV）等三种心功能指标，三种方法检查前后不超过1周。结果64SCT与Echo在测定左室功能方面（EDV、ESV、EF）具有高度相关性（r=0．85～0．90，P〈0．01）；64SCT与LVG在测定左室功能方面（EDV、ESV、EF）亦具有良好相关性（r=0．75～0．81，P〈0．01）。64SCT较Echo高估了EDV、ESV（P〈0．05），而EF的均值差异无显著性，一致性可被临床接受。64SCT较LVG低估了EF（P〈0．05）。三种参数测量方法均有较好的可重复性。结论64层螺旋CT与X线左室造影、超声心动图所测的EDV、ESV、EF具有较高的相关性、一致性和可重复性。64层螺旋CT是定量评价左心室功能准确、可靠的方法。

Evaluation of left ventricular function by using 64-slice spiral CT

Objective To investigate the clinical value of 64-slice spiral CT(64SCT) in assessing left ventricular function.Methods A total of 35 patients were suspected or confirmed with coronary artery disease underwent ECG-gated enhanced 64SCT,left ventriculography(LVG) and echocardiography(Echo).The data sets of 64SCT,LVG and Echo were reconstructed at both end-diastole and end-systole to measure left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),ejective fraction(EF).Three inspection methods lasted no more than a week.Results The parameters of left ventricular function(EDV,ESV,EF) obtained with 64SCT were significantly correlated with the Echo(r=0.85-0.90,P<0.01).EDV and ESV were significantly overestimated by 64SCT compared with Echo(P<0.05),whereas EF was not significantly different,consistency could be clinical acceptance.Evaluation of EDV,ESV,EF by linear regression analysis showed a good correlation between 64SCT and LVG,EF were significantly underestimated by 64SCT compared with LVG(P<0.05).Conclusion EDV,ESV and EF determined by 64SCT have excellent correlation,good reproducibility and an fair agreement with LVG and Echo.64SCT is an accurate and reliable method in quantitative evaluation of left ventricular function.