CAJ | 학술논문

目的：以核磁共振（magnetic resonance imaging ，MRI）为参照，探讨多排 CT （multi‐detector computed tomo‐graphy ，MDCT ）与实时三维超声心动图（real‐time 3‐dimensional echocardiography ，RT‐3DE）对左心房容积和功能评估的准确性，以期为临床寻找更可靠、便捷的左心房功能评价方法。方法42例患者，三天内完成 MDCT 、 RT‐3DE 和MRI 检查，然后对原始数据进行后处理及分析。得到左心房最大容积（maximal left atrial volume ，LAVmax）、左心房最小容积（minimal left atrial volume ，LAVmin），并计算左心房射血分数（left atrial ejection fraction ，LAEF）。通过 Bland‐Altman 分析法和配对 t检验分析 MDCT 和 MRI 、RT‐3DE 和 MRI 两种检查方法间的一致性。通过 Bland‐Altman 分析法评估 MDCT 、RT‐3DE 和 MRI 操作者测量值的一致性。结果通过 MDCT 和 MRI 、RT‐3DE 和 MRI 的两两对比，对左心房容积和功能进行测量，所得的测量指标之间差异无显著性（ P ＞0．05）。 MDCT 和 MRI 、RT‐3DE 和 MRI 对左心房容积和功能测量值的一致性较好。对左心房容积和功能指标的测量结果，操作者间的一致性 MDCT 优于 MRI ，MRI 优于RT‐3DE 。结论与 MRI 相比，MDCT 及 RT‐3DE 在左心房容积和功能测量方面准确性均较高，相比起来 MDCT 更有优势，可“一站式”检查同时评估冠状动脉并且较准确的测量左心房容积及功能。
목적：이핵자공진（magnetic resonance imaging ，MRI）위삼조，탐토다배 CT （multi‐detector computed tomo‐graphy ，MDCT ）여실시삼유초성심동도（real‐time 3‐dimensional echocardiography ，RT‐3DE）대좌심방용적화공능평고적준학성，이기위림상심조경가고、편첩적좌심방공능평개방법。방법42례환자，삼천내완성 MDCT 、 RT‐3DE 화MRI 검사，연후대원시수거진행후처리급분석。득도좌심방최대용적（maximal left atrial volume ，LAVmax）、좌심방최소용적（minimal left atrial volume ，LAVmin），병계산좌심방사혈분수（left atrial ejection fraction ，LAEF）。통과 Bland‐Altman 분석법화배대 t검험분석 MDCT 화 MRI 、RT‐3DE 화 MRI 량충검사방법간적일치성。통과 Bland‐Altman 분석법평고 MDCT 、RT‐3DE 화 MRI 조작자측량치적일치성。결과통과 MDCT 화 MRI 、RT‐3DE 화 MRI 적량량대비，대좌심방용적화공능진행측량，소득적측량지표지간차이무현저성（ P ＞0．05）。 MDCT 화 MRI 、RT‐3DE 화 MRI 대좌심방용적화공능측량치적일치성교호。대좌심방용적화공능지표적측량결과，조작자간적일치성 MDCT 우우 MRI ，MRI 우우RT‐3DE 。결론여 MRI 상비，MDCT 급 RT‐3DE 재좌심방용적화공능측량방면준학성균교고，상비기래 MDCT 경유우세，가“일참식”검사동시평고관상동맥병차교준학적측량좌심방용적급공능。
Objective This study was designed to compare the accuracy of multi‐detector computed tomography (MDCT) and real‐time 3‐dimensional echocardiography (RT‐3DE) for left atrial (LA) volume and function assessment with magnetic resonance imaging (MRI) .Methods A total of 42 patients underwent MDCT ,MRI and RT‐3DE examina‐tions within 3 days .LAVmax ,LAVmin ,and LAEF data were obtained .Intermotality agreement was tested through Bland‐Altman analysis and paired t test .Interobserver variability was tested through Bland‐Altman analysis .Results For LAVmax ,LAVmin ,and LAEF measurements ,there was no significant difference by MDCT and RT‐3DE in comparison with MRI ( P > 0 .05) .Furthermore ,MDCT and RT‐3DE showed good intermotality agreement with MRI for LA volume and LAEF .For the interobserver variability ,MDCT was best ,then MRI ,followed RT‐3DE .Conclusion MDCT and RT‐3DE can provide highly reliable measurements of LA volume and function and information .However ,MDCT can ex‐amine coronary artery and cardiac function at the same time .