背向散射积分定量分析左心房超声云雾影与血栓形成的研究

目的：探讨超声背向散射积分技术用于检测风湿性心脏病二尖瓣狭窄患者的左心房超声云雾影(SEC)的临床应用价值。方法：应用HP Sonos—5500型彩色超声诊断仪检测75例风湿性心脏病二尖瓣狭窄患者和35例正常人左房及左室的IBS值和与房间隔IBS值标化值，以背向散射积分百分比(IBS％)表示。结果：对SEC的研究表明，重度SEC的IBS％值明显高于轻度SEC及无SEC组。并与SEC定性分级相关性良好。左房IBS％值越高越易形成左房超声云雾影及房颤。结论：IBS技术作为检测风湿性心脏病二尖瓣狭窄患者的左心房超声云雾影的一种新技术、新方法，可以对左房血液密度进行定量，能为左房不同的血液状态提供客观指标。IBS％值大于38％作为区分重度SEC与中度SEC的诊断标准，其效感性、特异性、准确性分别为91．67％、82．35％、82．60％。IBS％值大于26％作为区分中度SEC与轻度SEC的诊断标准，其敏感性、特异性、准确性分别为89．47％、77．27％、80．95％。而IBS％值小于20％为无SEC与轻度SEC的诊断标准，其敏感性、特异性、准确性分别为86．67％、76．09％、80．26％。

Integrated Backscatter Quantitative Analysis of Left Atrial Spontaneous Echo Contrast and Its Relationship with Thrombus Formation

Objective:To evaluate the clinical application of integrated backscatter(IBS)quantifying left atrial spontaneous echo contrast(SEC)and detecting thrombus formation in patients with rheumatic mitral stenosis.Methods:IBS of 75 patients with rheumatic mitral stenosis and of 35 normal control subjects were analyzed with HP Sonos 5500 sonograph.IBS of left atrium and left ventricule were measured and standardized by IBS of interatrial septum and expreessed as IBS%.Results:IBS of severe SEC were higher than mild SEC and no SEC.The left atrial IBS% correlated well with the qualitative grades.The higher the IBS% value of a patient,the more liable to form left atrial SEC and atrial fibrillation.Conclusions:IBS is a new method to evaluate left atrial SEC of patients with rheumatic mitral stenosis,it is an objective index for different blood stasis in left atrium.Using IBS 38% in left atrium as a cutoff value,the diagnostic sensitivity?specificity?accuracy of severe SEC were 91 67%?82 35% amd 82 60% respectively.Using IBS>26% in left atrium as a cutoff value,the diagnostic sensitivity?specificity?accuracy of moderate SEC were 89 47%?77 27% and 80 95% respectively.Using IBS<26% in left atrium as a cutoff value,the diagnostic sensitivity?specificity?accuracy of mild SEC were 86 67%?76 09% and 80 26%.