定量组织速度成像技术评价急性心肌梗死后左室重构的左室功能  

Left ventricular function of ventricular remodeling in patients after acute myocardial infarction evaluated by quantitative tissue velocity imaging

作　　者：管敏[1] 朱阿丽[1] 周晓东[1] 穆新英[1] 许光瑜[1] 

机构地区：[1]大连市第二人民医院超声室,辽宁大连116011

出　　处：《中国医学影像技术》2005年第6期893-896,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的　应用定量组织速度成像技术对心肌梗死后左室重构的左心功能进行评价,以探讨其应用价值。方法　用定量组织速度成像技术测定22例健康者及临床确诊的29例心肌梗死后左室重构的冠心病患者的左室壁各节段的收缩期峰值速度(VS),舒张早期速度(VE),舒张晚期速度(VA) 和VE/VA 比值。测定二尖瓣口血流频谱的快速充盈速度(E),左房收缩充盈速度(A)和E/A值。容积法测左室射血分数,左室舒张末期容积指数(LVEDVI),左室收缩末期容积指数(LVESVI)及球形指数,并与正常组比较。结果　心脏左室长轴方向上心梗组前壁,侧壁,下壁各节段,后间隔心尖段VS 明显下降(P<0.01),后间隔基底段和中间段VS 无明显差异(P>0.05);心梗组几乎各节段VE、VA、VE/VA 与正常组相比有显著差异(P<0.05)。各节段平均VS 与左室射血分数,球形指数等呈线性相关(r值分别为0.79,0.68,P<0.01),舒张期功能参数平均VE/VA 与二尖瓣E/A比值之间存在高度相关性(r=0.62,P<0.01)。心梗组LVEDVI和LVESVI明显增大(P<0.01)。结论　定量组织速度成像可客观定位定量的反映心肌梗死局部心肌组织的收缩及舒张功能,又能体现心肌梗死后左室重构的整体功能,为心肌梗死后左室重构的心功能的评价提供了客观依据。Objective To investigate the clinical value of quantitative tissue velocity imaging (QTVI) for assessment of left ventricular (LV) remodeling and systolic and diastolic function after acute myocardial infarction in patients. Methods The segmental left ventricular wall motion velocity was measured in 22 normal subjects and 29 patients after acute myocardial infarction, and the peak velocity of LV regional myocardium during systole (V_S), early diastole (V_E) and atrial contraction (V_A). V_E/V_A ratio were also calculated. Mitral value peak flow velocities during early diastole (E) and atrial contraction (A), were also measured and E/A ratio was calculated. LV ejection fraction(EF), sphericity index (SI), LV end-systolic and end-diastolic volume (LVESVI and LVEDVI) were calculated The parameters were analyzed between the two groups. Results Expects at the base and middle segments of posterior inter ventricular septum, V_S of the segmental LV wall in infarcted group were significantly decreased (P<0.01). V_E, V_A, V_E/V_A of the segmental LV wall in infarcted group were all significantly decreased (P<0.05). The mean peak systolic velocity of the segmental LV wall correlated positively to LVEF and SI (r=0.79, 0.68 respectively, P<0.01). The mean V_E/V_A ratio of segmental LV wall correlated positively to E/A ratio of mitral value flow (r=0.62, P<0.01). SI, LVESVI and LVEDVI in infarcted group were significantly increased (P<0.01). Conclusion QTVI is a rapid, comprehensive, and valuable method to quantitatively assess LV remodeling and systolic and diastolic function after acute myocardial infarction.

关 键 词：定量组织速度成像 心肌梗塞 心室复建 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.22[医药卫生—诊断学]