组织同步显像对冠心病患者左心室非同步运动的研究  

Research on evaluating dyssynchronicity of left ventricle in patients with coronary artery disease using tissue synchronization imaging

作　　者：田家玮[1] 任敏[1] 孙立涛[1] 冷晓萍[1] 苏雁欣[1] 

机构地区：[1]哈尔滨医科大学附属第二医院超声科,150086

出　　处：《中华超声影像学杂志》2005年第6期406-409,共4页Chinese Journal of Ultrasonography

基　　金：黑龙江省科技厅攻关课题(GC04C30101)

摘　　要：目的应用组织同步显像(TSI)研究冠心病患者左心室心肌运动非同步性和速度特征及其临床意义。方法采用TSI技术对30例冠心病患者(病例组)和30例正常人(对照组)的左心室心肌进行检测,获取左心室各节段心肌长轴方向的组织运动图像,测量各节段心肌达峰值速度时间和峰值速度。结果对照组各节段心肌运动同步性较好,彩色编码多为均一分布的绿色,仅少数节段表现为浅黄色;病例组各节段心肌同步运动规律消失,心肌彩色编码表现为绿～黄～红明显不均,编码为黄色或红色的节段数明显增多(P<0.005)。病例组前壁及室间隔各节段平均达峰值速度时间较对照组增高,差别具有显著性意义(P<0.001)。病例组峰值速度从基底到心尖段逐渐递减的梯度样分布规律消失,前壁各节段及室间隔瓣环、基底段、中间段平均峰值速度较对照组降低(P<0.05)。结论TSI是一种无创伤性定量评价局部心肌达峰值速度时间和峰值速度的新方法,对直观、快速判断心肌缺血及梗死节段有重要价值。Objective To evaluate the regional myocardial dyssynchronicity and velocity of left ventricle (LV) in patients with coronary artery disease(CAD) with tissue synchronization imaging(TSI). Methods The LV myocardium segments of 30 patients with CAD (case group) and 30 normal controls(control group) were detected by TSI technique and the tissue velocity images of longitudinal myocardium were obtained. The time-to-peak velocity(Tp) and the peak velocity(Vp) of all myocardial segments were examined, then the results were compared. Results The myocardium had good synchronicity in control group and was color-coded by well-distributed green, only minority displayed pale yellow. But in case group, the rule of myocardial synchrony disappeared. The myocardium was color-coded by bad-distributed colors of green, yellow or red. The segments coded by yellow or red in case group were much more than those of control group(P<(0.005)). Compared with control group, the Tp of LV anterior wall and interventricular septum(IVS) in case group was much higher than that of control group(P<(0.001)). The apex-to-base gradient of tissue velocity was lost in case group. The mean Vp of all segments except apical segment of IVS in case group decreased more significantly than that of control group(P<(0.05)). Conclusions TSI is a new and non-invasive investigation, which can quantitatively assess the regional myocardial Tp and Vp, judge the myocardial segments of ischemia or infarction directly and quickly.

关 键 词：冠心病患者 左心室 同步运动 组织 显像 峰值速度 心肌运动 彩色编码 对照组 病例组 临床意义 运动规律 分布规律 定量评价 无创伤性 心肌缺血 同步性 室间隔 节段 正常人 I技术 时间 显著性 TSI 黄色 平均 前壁 基底 

分 类 号：R541.4[医药卫生—心血管疾病] R544.1[医药卫生—内科学]