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戴丽雅,陈方红,蓝文胜,赖小伟,周宁.单心动周期实时三维超声心动图与心脏磁共振 诊断肥厚型心肌病的对照研究[J].浙江中西医结合杂志,2018,28(9):
单心动周期实时三维超声心动图与心脏磁共振 诊断肥厚型心肌病的对照研究
Comparison study of Single beat real-time three-dimensional echocardiography andCardiac magnetic resonance in diagnosis of Hypertrophic cardiomyopathy
投稿时间:2017-11-08  修订日期:2018-07-27
DOI:
中文关键词:  单心动周期实时三维超声心动图  肥厚型心肌病  心脏磁共振
英文关键词:Single beat real-time three-dimensional echocardiography  Hypertrophic cardiomyopathy  Cardiac magnetic resonance
基金项目:
作者单位E-mail
戴丽雅 丽水市中心医院 523768180@qq.com 
陈方红* 丽水市中心医院 zhejiangcfh@sina.com 
蓝文胜 丽水市中心医院  
赖小伟 丽水市中心医院  
周宁 丽水市中心医院  
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中文摘要:
      目的 分析肥厚型心肌病(HCM)患者的单心动周期实时三维超声心动图(sRT-3DE)与心脏磁共振(CMR)的影像征象,比较两者在HCM诊断中的价值。方法 对临床确诊的52例肥厚型心肌病患者的二维超声心动图、sRT-3DE及CMR表现进行回顾分析,并对诊断为心尖肥厚型心肌病(AHCM)但超声心动图(ECG)未提示的患者加做心腔造影。结果 对比sRT-3DE与CMR的相关参数,LVEDV、LVESV、LVSV、LVEF均无显著差异,显示出较高相关性。52例HCM患者中,CMR提示心尖型HCM患者8例,常规ECG提示4例,加做心腔造影后提示AHCM也为8例。结论sRT-3DE与CMR在测量左室参数上具有良好的相关性。CMR在提示AHCM中较常规ECG敏感,但结合超声造影等技术可提高诊出率。sRT-3DE和CMR在诊断HCM中均有很高的价值,超声具有价格便宜、操作简便、无辐射、能准确评估心功能等优点,可作为临床诊断和随访HCM的首选检查;CMR价格较贵、操作复杂,但在组织学特性方面有较大的优势,可作为必要时的补充检查。
英文摘要:
      Objective: To analyze the imaging features and compare the value of single beat real-time three-dimensional echocardiography (sRT-3DE) and cardiac magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM). Methods: Two-dimensional echocardiography (2DE), sRT-3DE and CMR findings of 52 HCM patients were retrospectively analyzed. Contrast echocardiography was performed for patients who have already been diagnosed with AHCM but missed by ECG. Results: Parameters of sRT-3DE and CMR are compared, LVEDV、LVESV、LVSV and LVEF show no significant difference and have a high correlation. Of the 52 patients with HCM, CMR showed 8 patients with AHCM, ECG showed 4 patients and 8 patients with AHCM before and after performing contrast echocardiography. Conclusions: sRT-3DE has a good correlation with CMR in measuring left ventricular parameters. CMR is more sensitive than ECG in the diagnosis of AHCM, but the combination of ultrasound and other techniques can improve the diagnosis rate. sRT-3DE and CMR both have high value in the diagnosis of HCM. ECG is the first line imaging exam in patient with suspected HCM because of its low-cost、widespread availability、no radiation and accurate assessment of cardiac function. CMR is more expensive and complex to operate, but has greater advantages in terms of histological features and can be used as a supplementary exam if necessary.
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