CAJ | 학술논문

目的探讨磁共振在急性病毒性心肌炎中的诊断价值.方法 2011年6月至2013年6月,入选佛山市顺德区第一人民医院的疑似急性病毒性心肌炎患者30例进行前瞻性研究.以临床诊断作为参照,评价磁共振诊断急性病毒性心肌炎的灵敏度、特异度、阳性预测值、阴性预测值及准确度,并对比不同的磁共振扫描方法和路易斯湖标准在急性病毒性心肌炎中的诊断价值.结果在30例疑似患者中,19例(63.33％)临床诊断为急性病毒性心肌炎.诊断急性病毒性心肌炎的灵敏度、特异度、阳性预测值、阴性预测值和准确度磁共振心肌水肿比(ER)分别为57.89％、72.73％、78.57％、50.00％和63.33％,磁共振心肌早期钆增强成像技术计算的全心肌相对增强(gRE)分别为78.95％、63.64％、78.95％、63.64％和73.33％,磁共振心肌延迟强化成像(LGE)分别为78.95％、54.55％、75.00％、60.00％和70.00％,磁共振路易斯湖标准分别为84.21％、81.82％、88.89％、75.00％和83.33％.磁共振路易斯湖标准的灵敏度、特异度、阳性预测值、阴性预测值和准确度均高于其他3种扫描方法(P均＜0.05);ER的特异度高于gRE和LGE(P均＜0.05);gRE的灵敏度、阴性预测值、准确度均高于ER(P均＜0.05),与LGE比较差异无统计学意义(P均＞0.05).结论磁共振在急性病毒性心肌炎中有较高的诊断价值.
목적 탐토자공진재급성병독성심기염중적진단개치.방법 2011년6월지2013년6월,입선불산시순덕구제일인민의원적의사급성병독성심기염환자30례진행전첨성연구.이림상진단작위삼조,평개자공진진단급성병독성심기염적령민도、특이도、양성예측치、음성예측치급준학도,병대비불동적자공진소묘방법화로역사호표준재급성병독성심기염중적진단개치.결과 재30례의사환자중,19례(63.33％)림상진단위급성병독성심기염.진단급성병독성심기염적령민도、특이도、양성예측치、음성예측치화준학도자공진심기수종비(ER)분별위57.89％、72.73％、78.57％、50.00％화63.33％,자공진심기조기구증강성상기술계산적전심기상대증강(gRE)분별위78.95％、63.64％、78.95％、63.64％화73.33％,자공진심기연지강화성상(LGE)분별위78.95％、54.55％、75.00％、60.00％화70.00％,자공진로역사호표준분별위84.21％、81.82％、88.89％、75.00％화83.33％.자공진로역사호표준적령민도、특이도、양성예측치、음성예측치화준학도균고우기타3충소묘방법(P균＜0.05);ER적특이도고우gRE화LGE(P균＜0.05);gRE적령민도、음성예측치、준학도균고우ER(P균＜0.05),여LGE비교차이무통계학의의(P균＞0.05).결론 자공진재급성병독성심기염중유교고적진단개치.
Objective To assess the diagnostic value of cardiac magnetic resonance (CMR) in patients with acute viral myocarditis.Methods Thirty patients with suspected acute viral myocarditis admitted in first people's hospital of Shunde from June 2011 to June 2013 were included in this prospective study.The diagnostic sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and accuracy of acute viral myocarditis were evaluated by clinical diagnosis.Diagnostic value among different scan methods and Lake Louise criteria were compared.Results Acute viral myocarditis was diagnosed in 63.33％ (19/30) patients.Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 57.89％,72.73％,78.57％,50.00％,63.33％,respectively by edema imaging(ER).Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 78.95％,63.64％,78.95％,63.64％,73.33％,respectively using global relative enhancement (gRE).Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 78.95％,54.55％,75.00％,60.00％,70.00％,respectively using late gadolinium enhancement (LGE) criteria.Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 84.21％,81.82％,88.89％,75.00％,83.33％ using Lake Louise criteria.The sensitivity,specificity,PPV,NPV,and diagnostic accuracy using Lake Louise criteria were significantly higher than using ER,gRE,LGE alone (all P ＜ 0.05).Specificity was higher using ER than using gRE and LGE(both P ＜ 0.05).The sensitivity,NPV,and diagnostic accuracy were significantly higher using gRE than using ER (all P ＜ 0.05) and was similar as using LGE (all P ＞ 0.05).Conclusion Cardiac magnetic resonance is an excellent imaging modality for the diagnosis of acute viral myocarditis.