定量组织速度成像与二维斑点追踪成像技术评价扩张型心肌病患者左心室扭转运动特征的对照研究  

Comparative study of quantitative tissue velocity imaging and two-dimensional speckle tracking imaging in evaluation of left ventricular twist of patients with dilated cardiomyopathy

作　　者：张玲利[1] 王新房[1] 谢明星[1] 吕清[1] 杨亚利[1] 王静[1] 贺林[1] 

机构地区：[1]华中科技大学附属协和医院超声影像科,湖北省分子影像重点实验室,湖北武汉430022

出　　处：《中国医学影像技术》2007年第10期1507-1510,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的评价定量组织速度成像(QTVI)技术检测扩张型心肌病患者左心室扭转运动(LVtw)特征的可行性,并比较QTVI与超声二维斑点追踪成像技术(STI)两种技术的特点。方法应用QTVI和STI成像模式,结合同步记录的心电图,分别于左室基底部及心尖部短轴观评价35例扩张型心肌病患者与32例健康志愿者左心室扭转运动特征。QTVI技术以收缩期左室心尖部与心底部侧壁间隔位移差(SD1-s)的差值来计算左室扭转运动指数(TMI),STI技术以左室心尖部旋转值减去基底部旋转值来定义左室扭转峰值(Ptw)。结果从左室心尖来看,正常人LVtw运动主要表现为心底部顺时针旋转和心尖部逆时针旋转,心脏整体表现为心动周期内逆时针方向为主的扭转运动。DCM患者LVtw运动于收缩期仍维持心底部顺时针旋转、心尖部逆时针旋转及心脏整体收缩期逆时针方向的扭转运动,但其左室扭转运动指数TMI(8.43±2.27vs12.33±3.29)及扭转峰值Ptw(6.56±2.19vs14.44±1.55)均显著减低。TMI与Ptw显著正相关。结论DCM患者组收缩期左室扭转运动指数TMI及扭转值减低对于左室收缩功能有很大影响。高帧频的QTVI技术为简便、客观地评估左心室扭转运动特征提供了全新的定量工具。Objective To evaluate the feasibility and accuracy of left ventricular twist （LVtw） using quantitative tissue velocity imaging （QTVI） and two-dimensional ultrasound speckle-tracking imaging （STI）, and to compare the characteristics of the two imaging patterns. Methods Basal and apical LV short-axis images were acquired in 35 patients with dilated cardiomyopathy （DCM） and in 32 healthy volunteers. Using commercially available Q-analysis software, regional LV velocity imaging and displacement profiles were obtained in each plane. LV systolic lateral-septal maximum displacement difference （SDl-s） was defined as LV lateral wall velocity relative to the septum. LV twist motility index （TMI） was defined as apical LV SDl-s relative to the base in systolic phase. Using commercially available two-dimensional strain software, time domain speckle tracking was performed, and regional LV rotation were obtained in each plane. LVtw was defined as apical LV rotation relative to the base. Results As seen from the apex, the normal LV performed a wringing motion with a clockwise rotation at the base and counter clock wise rotation at the apex. LV TMI （8.43±2.27 vs 12.33±3.29） and LVtw （6.56±2.19 vs 14.44±1.55） were significantly reduced in patients with DCM compared with healthy volunteers. Conclusion LV TMI and LVtw were significantly reduced in DCM impact on global LV systolic function in patients with DCM. QTVI and two-dimensional ultrasound STI both can evaluate LV twist. High frame-rate QTVI technique would be more robust in evaluation the LV twist in clinical use.

关 键 词：超声心动描记术 定量组织速度成像 斑点追踪成像 扩张型心肌病 

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