应变率成像定量评价缺血心肌再灌注前后左室壁运动的临床研究  

Quantitative analysis of segmental function of left ventricle pre-and post-reperfusion of ischemic myocardium in patients with coronary artery disease:a comparison between strain rate imaging and tissue velocity imaging

作　　者：唐屹青[1] 王建华[2] 杜昕[2] 杜丽娟[2] 

机构地区：[1]上海交通大学医学院苏州九龙医院超声诊疗中心,江苏苏州215021 [2]北京军区总医院超声科,北京100700

出　　处：《中国医学影像技术》2007年第6期869-873,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的：探讨应变率成像（SRI）和组织速度成像（TVI）在冠心病患者缺血心肌再灌注前后左室局部功能定量评价中的应用价值。方法：对比分析接受PTCA＋支架植入术的冠心病患者30例，平均（48．35±9．12）岁。术前、术后3天和3个月时缺血心肌节段SRI参数和TVI参数的变化。结果：①289个缺血节段中，心肌收缩期峰值应变（PSS）、收缩期和舒张早期峰值应变率（PSSR、PESR）、心肌收缩期峰值速度（Vs）和舒张早期峰值速度（Ve）对缺血节段的检出率分别为83．3％、78．8％、50．00、11．1％和16．7％，SRI参数对缺血节段的检出率显著高于TVI参数（P％0．05～0．01）。②术后3天，缺血节段PSS和PSSR显著增高；术后3个月大部分PSS和PSSR恢复正常。结论：SRI比TVI更敏感地反映心肌局部功能的改变，对冠心病的诊断和疗效评价有重要意义。Objective To compare the value of strain rate imaging （SRI） and tissue velocity imaging （TVI） in segmental analysis of left ventricular function in patients of coronary artery disease （CAD） pre- and post-reperfusion of ischemic myocardium. Methods SRI and TVI parameters were obtained in 30 CAD patients received PTCA＋stent treatment before, 3 days and 3 months after the procedure, and 20 age-and gender-matched volunteers were included as control group. Results ① Among 289 ischemic segments, the detect rates of ischemic segments of peak systolic strain （PSS）, peak systolic strain rate （PSSR）, peak early diastolic strain rate （PESR）, peak systolic velocity （Vs） and peak early diastolic velocity （Ve） were 83.3%, 78.8%, 50.0%, 11.1% and 16.7% respectively, indicating a significantly higher rate of SRI parameters than TVI parameters. ② PSS and PSSR of ischemic segments showed significant increase at 3 days after procedure and most segments showed a complete recovery at 3 months after reperfusion. Conclusion SRI parameters are more sensitive and accurate than TVI parameters for the segmental functional evaluation of left ventricle, and may play an important role in the diagnosis and therapeutic estimation of coronary artery disease.

关 键 词：超声心动描记术 应变率成像 冠心病 心肌缺血和再灌注 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R541.4[医药卫生—内科学]