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西安交通大学附属三二〇一医院超声医学科
纸质出版日期:2020,
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[1]唐中才,李昱,柏艳红.斑点追踪技术与心导管检查鉴别诊断缩窄性心包炎和限制型心肌病的价值[J].临床超声医学杂志,2020,22(12):907-910.
TANG Zhongcai, LI Yu, BAI Yanhong. Value of speckle tracking imaging and cardiac catheterization in the differential diagnosis of constrictive pericarditis and restrictive cardiomyopathy[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(12):907-910.
[1]唐中才,李昱,柏艳红.斑点追踪技术与心导管检查鉴别诊断缩窄性心包炎和限制型心肌病的价值[J].临床超声医学杂志,2020,22(12):907-910. DOI: 10.16245/j.cnki.issn1008-6978.2020.12.011.
TANG Zhongcai, LI Yu, BAI Yanhong. Value of speckle tracking imaging and cardiac catheterization in the differential diagnosis of constrictive pericarditis and restrictive cardiomyopathy[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(12):907-910. DOI: 10.16245/j.cnki.issn1008-6978.2020.12.011.
目的探讨斑点追踪(STI)技术与心导管检查对缩窄性心包炎(CP)和限制型心肌病(RCM)的鉴别诊断价值。方法选取经我院手术病理证实的48例CP患者(CP组)和30例RCM患者(RCM组)
两组均行STI和心导管检查
分析STI和心导管检查指标的差异。绘制受试者工作特征(ROC)曲线分析两种检查方法对CP与RCM的鉴别诊断价值
应用Logistic回归模型得出STI联合值和心导管联合值
进一步分析其鉴别诊断效能。结果 STI检查显示两组患者心尖、乳头肌、心底各切面的圆周应变比较
差异均无统计学意义;CP组心尖、乳头肌、心底各切面的径向应变(RS)、纵向应变(LS)均高于RCM组
差异均有统计学意义(均P<0.05)。心导管检查显示
两组患者肺动脉楔压、左室舒张压、右室收缩压比较
差异均无统计学意义;CP组主动脉收缩压和肺动脉收缩压均低于RCM组
差异均有统计学意义(均P<0.05)。ROC曲线显示
心尖RS、心尖LS、乳头肌RS、乳头肌LS、心底RS、心底LS、主动脉收缩压及肺动脉收缩压鉴别诊断CP与RCM的曲线下面积分别为0.915、0.756、0.749、0.751、0.758、0.749、0.759、0.773;STI联合值和心导管联合值鉴别诊断CP与RCM的曲线下面积分别为0.917和0.852
差异无统计学意义(Z=1.245
P=0.213)。结论 STI技术和心导管检查均有助于CP与RCM的鉴别诊断
但STI技术的价值更高
具有无创性
值得临床推广应用。
Objective To explore the value of speckle tracking imaging(STI)and cardiac catheterization in the differential diagnosis of constrictive pericarditis(CP)and restrictive cardiomyopathy(RCM).MethodsForty-eight CP patients(CP group)and 30 RCM patients(RCM group)confirmed by surgery and pathology in our hospital were selected.Both two groups underwent STI and cardiac catheterization
and the differences of STI and cardiac catheterization indicators were analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the differential diagnosis value of the two methods for CP and RCM
the Logistic regression model was used to obtain the combined STI and cardiac catheterization values
and further analyze their diagnostic efficacy.ResultsSTI showed that there were no statistically significant differences in the circumferential strain(CS)of the apex
papillary muscle and fundus of the two groups
while the radial strain(RS)and longitudinal strain(LS)of the apex
papillary muscle and fundus of the CP group were higher than those of RCM group
and the differences were statistically significant(all P<0.05).Cardiac catheterization showed that the pulmonary wedge pressure
left ventricular diastolic pressure and right ventricular systolic pressure between the two groups were not statistically significant
while the aortic systolic pressure and pulmonary artery systolic pressure in CP group were lower than those in RCM group
the differences were statistically significant(all P<0.05).ROC curve showed that the area under the curve of apical RS
apical LS
papillary muscleRS
papillary muscle LS
heart base RS
heart base LS
aortic systolic pressure
pulmonary artery systolic pressure in the differential diagnosis of CP and RCM were 0.915
0.756
0.749
0.751
0.758
0.749
0.759
0.773
respectively.The area under the curve of STI and cardiac catheterization in the differential diagnosis of CP and RCM were 0.917 and 0.852
respectively
and the difference was not statistically significan(tZ=1.245
P=0.213).ConclusionSTI and cardiac catheterization are helpful for the differential diagnosis of CP and RCM
but STI is more valuable
with the advantages of non-invasive
and worthy of clinical application.
斑点追踪心导管检查缩窄性心包炎限制型心肌病
Speckle tracking imagingCardiac catheterizationConstrictive pericarditisRestrictive cardiomyopathy
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