三维与二维斑点追踪技术评价健康青年志愿者左心室心肌应变的研究  

The evaluation of left ventricular strain using speckle tracking echocardiography in normal young adults:comparison of three-dimensional and two-dimensional approaches

作　　者：刘艳午[1] 黄红梅[1] 曹礼庭[1] 顾鹏[1] 岳文胜[1] 熊云涛 蒋冰蕾[1] 

机构地区：[1]川北医学院附属医院超声诊断科四川省医学影像学重点实验室,四川南充637000

出　　处：《中华医学超声杂志（电子版）》2013年第8期639-644,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨三维斑点追踪技术(3D-STI)在评价左心室心肌应变中的应用价值与优势。方法采用二维斑点追踪技术(2D-STI)、3D-STI对30名健康青年志愿者进行心肌斑点追踪分析,比较两种方法获得的左心室心肌所有节段纵向、径向和圆周收缩期峰值应变值的大小、耗时及左心室不同水平收缩期峰值应变值的差异。结果使用3D-STI存储图像时间为(309.3±23.4)s,脱机分析时间为(305.5±11.2)s,使用2D-STI存储图像时间为(490.6±14.4)s,脱机分析时间为(1261.4±39.9)s,3D-STI耗时明显短于2D-STI,且差异有统计学意义(t=-21.81、69.94,P均<0.01)。3D-STI所测左心室整体收缩期径向应变峰值为(48.59±7.68)%,2D-STI所测左心室整体收缩期径向应变峰值为(33.25±7.27)%,3D-STI测值较2D-STI大,且差异有统计学意义(t=9.16,P<0.01);3D-STI所测左心室整体收缩期纵向及圆周应变峰值分别为(-17.66±3.14)%、(-17.13±2.29)%,2D-STI所测左心室整体收缩期纵向及圆周应变峰值分别为(-21.35±2.46)%、(-21.97±3.84)%,3D-STI测值较2D-STI小,且差异均有统计学意义(t=5.33、5.99,P均<0.01)。3D-STI示左心室径向、纵向及圆周收缩期峰值应变均在左心室中间部呈最大趋势,径向收缩期峰值应变在心尖部最小,圆周及纵向收缩期峰值应变则在基底部最小;2D-STI示左心室纵向、圆周收缩期峰值应变由基底部至心尖部有依次增大的趋势,径向收缩期峰值应变则与3D-STI规律相同。两种方法在两测试者间及同一测试者前后均值与差值于Bland-Altman图上呈一致性的变化趋势,具有较好的可重复性。结论 3D-STI是一种方便、快速及可重复性较好的评价左心室心肌应变的新方法,具有潜在的临床应用价值。Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in assessment of left ventricular (LV) strains. Methods Thirty healthy young adults examined by two-dimensional speckle tracking imaging (2D-STI) and 3D-STI. And the results of LV measurements were compared, which included mean peak systolic longitudinal strains, radial strains and circumferential strains. Also, the time consumption of these two methods was compared. Results The time needed for 3D-STI in acquisition and analysis of the images were (309.3±23.4)s, (305.5±11.2)s, while the time for 2D-STI were (490.6±14.4)s, (1261.4±39.9)s. The differences were signiifcant(t=-21.81, 69.94, both P<0.01). The global mean peak systolic radial strains was (48.59±7.68)%by 3D-STI and (33.25±7.27)%by 2D-STI. The difference was signiifcant(t=9.16, P<0.01). The global mean peak systolic longitudinal and circumferential strains were (-17.66±3.14)%, (-17.13±2.29)% by 3D-STI and (-21.35±2.46)%, (-21.97±3.84)% by 2D-STI. The differences were signiifcant(t=5.33, 5.99, both P < 0.01). The 3D-STI strains were different&nbsp;at different levels of LV. The longitudinal, circumferential and radial 3D-STI strains were largest at middle levels. However, 2D-STI strains didn′ t show such trend. Peak strains measured by 3D-STI and 2D-STI showed high inter-observer and intra-observer agreement in Bland-Altman chart. Conclusion 3D-STI is a novel, convenient and reproducible method to evaluate the strains of LV.

关 键 词：超声心动描记术 三维 应变 心室 

分 类 号：R445.1[医药卫生—影像医学与核医学]