摘要
目的探讨无对比剂全心冠状动脉血管成像(NCE-CMRA)技术对儿童川崎病冠状动脉病变的诊断价值,并分析川崎病相关炎症因子与冠状动脉病变发生发展的相关性。方法回顾性分析经临床确诊的61例川崎病患儿临床资料,总结分析NCE-CMRA影像资料,评估冠状动脉受累严重程度和血管累及分布情况;根据内径测量结果分为冠状动脉正常(NCAL)组和冠状动脉病变(CAL)组,比较两组患儿间的炎性指标差异,通过ROC曲线分析各炎性指标的敏感度并找出其截点;利用多元线性回归分析各炎症因子与冠状动脉病变严重程度的相关性。结果通过影像图像质量分级最终52例纳入研究,其中CAL组36例,NCAL组16例。分析显示CAL组患儿的PLT、CRP、ESR、D-二聚体水平均高于NCAL组,差异具有统计学意义(P<0.05),其中ESR敏感度最高。CAL组中PLT、CRP、D-二聚体与受累管径比值呈正相关,其中与CRP显著相关;ESR与受累血管长度、受累血管数目具有一定的相关性。结论无对比剂全心3D冠状动脉血管成像能够客观全面地显示儿童川崎病冠状动脉病变的影像特点及病变程度;PLT、CRP、ESR、D-二聚体升高是川崎病并发冠状动脉病变的高危因素,且水平越高,川崎病所致冠状动脉病变程度越严重。因此,NCE-CMRA和炎性指标联合诊断有助于儿童川崎病冠状动脉损害程度的准确评估,同时帮助临床了解川崎病的发病进程,进一步指导临床治疗。
Objective To investigate the diagnostic value of non-contrast whole-heart magnetic resonance coronary angiography(NCE-CMRA)in children with Kawasaki disease(KD)coronary artery lesion(CAL),and to analyze the correlation between Kawasaki disease-related inflammatory factors and the occurrence and development of coronary artery lesion.Methods In a retrospective analysis of 61 children with clinically confirmed Kawasaki disease,sort out the clinical data,summarize and analyze the image data of NCE-CMRA,and evaluate the severity and distribution of coronary artery involvement.According to the internal diameter measurement results,they were divided into normal coronary artery(NCAL)group and coronary artery lesion(CAL)group.The differences of inflammatory indexes between the two groups were compared.The sensitivity of each inflammatory index was analyzed by ROC curve and its cut-off point was found.Multiple linear regression was used to analyze the correlation between inflammatory factors and CAL severity.Results 52 cases were included in the experimental analysis through image quality grading,including 36 cases in CAL group and 16 cases in NCAL group.Statistical analysis showed that the levels of PLT,CRP,ESR and D-dimer in CAL group were higher than those in NCAL group(P<0.05),and the sensitivity of ESR was the highest.In CAL group,PLT,CRP,D-dimer were positively correlated with the ratio of involved pipe diameter,among which CRP was significantly correlated;ESR was correlated with the length and number of involved vessels.Conclusion NCE-CMRA can objectively and accurately display the imaging characteristics and degree of coronary artery disease in children with Kawasaki disease;The increase of PLT,CRP,ESR and D-dimer is the high risk factor of Kawasaki disease complicated with CAL,and the higher the level,the more serious the degree of coronary artery disease caused by Kawasaki disease.Therefore,the combined diagnosis of NCE-CMRA and inflammatory indexes is helpful to the early diagnosis and prognosis of coronary artery disease in children with Kawasaki disease.
作者
马玉荣
梁娟
韩娜
胡万均
王鹏飞
姜艳丽
艾凯
张静
MA Yurong;LIANG Juan;HAN Na(Department of Magnetic Resonance,Lanzhou University Second Hospital,Lanzhou,Gansu Province 730000,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第3期460-465,共6页
Journal of Clinical Radiology
基金
甘肃省科技计划项目(创新基地和人才计划)临床医学研究中心建设资助项目(编号:21JR7RA438)。
关键词
冠状动脉
川崎病
炎症因子
磁共振成像
Coronary angiography
Kawasaki disease
Inflammatory factors
Magnetic resonance
