MCE联合心脏MRI对缺血性心肌病的诊断价值

目的 探讨心肌声学造影(MCE)联合心脏磁共振成像(MRI)对缺血性心肌病(ICM)的诊断价值。方法 选取2020年10月至2021年10月在本院诊治的80例ICM患者为观察组,另按倾向性匹配原则随机选取同期在本院行健康体检者80例为对照组,两组均行MCE和心脏MRI检查,比较两组左室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)、左心室收缩末期容积指数(LVESVI)、二尖瓣舒张早与晚期血流峰值速度比值(E/A)、二尖瓣舒张早期血流峰值流速(E)、舒张晚期峰值运动速度(Am)的差异。使用ROC曲线评估MCE、心脏MRI检查及其联合检查对ICM的诊断效能。结果 MCE检查显示,观察组LVESVI高与对照组,LVEF、E/A、Am、E均低于对照组(均P＜0.05)；心脏MRI检查显示,观察组LVESVI高与对照组,LVEF、E/A、Am、E均低于对照组(均P＜0.05)。MCE与心脏MRI检查的观察组Am比较差异有统计学意义(P＜0.05)。ROC曲线分析结果显示,MCE和心脏MRI诊断ICM的AUC分别为0.781和0.762,敏感性、特异性分别为85.00%、71.25%和75.00%、77.50%；两者联合应用的AUC为0.819,敏感性、特异性分别为93.75%、70.00%(均P＜0.05)；MCE和心脏MRI联合应用诊断ICM的价值高于单独应用(Z=2.196、2.124,P=0.028、0.034)。结论 MCE联合心脏MRI对ICM有较好的诊断价值,于临床诊断有一定的参考性。

Diagnostic value of MCE combined with cardiac MRI in ischemic cardiomyopathy

Objective To explore the diagnostic value of myocardial contrast echocardiography (MCE) combined with cardiac magnetic resonance imaging (MRI) in patients with ischemic cardiomyopathy (ICM). Methods A total of 80 patients with ICM treated in the hospital were enrolled as observation group between October 2020 and October 2021, while 80 healthy volunteers undergoing physical examination during the same period were enrolled as control group according to the principle of orientation matching. Both groups underwent MCE and cardiac MRI examination. The difference in left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), ratio of early blood flow peak velocity to end-diastolic peak blood flow velocity (E/A), late diastolic motion velocity (Am) and early mitral valve diastolic blood flow peak velocity (E) between the two groups were compared. The diagnostic efficiency of MCE, cardiac MRI and combined detection for ICM was evaluated by ROC curves. Results MCE showed that LVESV in observation group was higher than that in control group, while LVEF, E/A, Am and E were lower than those in control group (P<0.05). The examination of cardiac MRI showed that LVESV in observation group was higher than that in control group, while LVEF,E/A, Am and E were lower than those in control group (P<0.05). There were significant differences in Am between MCE and cardiac MRI in observation group (P<0.05). The results of ROC curves analysis showed that AUC, sensitivity and specificity of MCE and cardiac MRI in the diagnosis of abnormal myocardial function were (0.781, 0.762), (85.00%, 71.25%) and (75.00%, 77.50%), respectively. AUC, sensitivity and specificity of combined detection were 0.819, 93.75% and 70.00%, higher than those of single index (P<0.05). Conclusion MCE combined with cardiac MRI has good diagnostic value in ICM patients, with certain reference for clinical diagnosis.