定量组织速度成像评价扩张型心肌病患者左心室扭转运动特征  

The assessment of left ventricular twist in dilated cardiomyopathy using quantitative tissue velocity imaging

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

机构地区：[1]华中科技大学同济医学院协和医院超声影像科湖北省分子影像重点实验室,武汉430022

出　　处：《中华超声影像学杂志》2007年第12期1034-1037,共4页Chinese Journal of Ultrasonography

摘　　要：目的评价定量组织速度成像（QTVI）技术观察扩张型心肌病患者左心室扭转运动特征的可行性。方法32例健康成年志愿者和30例扩张型心肌病（DCM）患者，应用QTVI获取标准左室心底部及心尖部短轴图像，分别获取其室间隔与侧壁心肌的心肌运动曲线，比较室间隔与侧壁心肌运动的收缩期峰值速度（Vs）及侧壁-间隔位移速度差（lateral-septal displacement diference，Dh）、快速充盈期和心房收缩期的速度（Ve和Va），并观察其运动方向。左室扭转运动指数（torsional motility index，TMI）由收缩期左室心尖部与心底部D1-5的差值来计算。结果正常人与DCM患者左室短轴观室间隔和侧壁的反向运动造成了：①左室心底部收缩期舒张期逆时针（解旋）运动；②左室心尖部收缩期环向逆时针旋转和舒张期顺时针（解旋）运动。收缩期心脏整体主要表现为逆时针方向的扭转运动。DCM组较正常组收缩期心尖部与心底部D1-5均显著减低，导致其收缩期左室扭转运动指数减低（6．56±2．19对14．44±1．55，P〈0．05）。左室TMI与左室射血分数显著正相关（Spearman相关系数r=0．517，P=0．000）。结论DCM患者收缩期左室扭转运动指数减低对于左室收缩功能有很大影响。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）. Methods Basal and apical LV short-axis views were acquired in 30 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 view. Peak tissue velocities of LV regional myocardium tissue during systole（ Vs）, early diastole （Ve）, LA contraction（Va）, LV ejection fraction （LVEF）, mitral valve peak flow velocity and E/A ratio were measured. LV torsional motility index（TMI） was defined as apical LV lateral-septal maximal displacement diference（D1-5） 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 counterclockwise rotation at the apex. LV TMI was significantly reduced in patients with DCM （6.56 ±2.19 vs 14.44 ±1.55, P d0.05） compared with healthy volunteers because of lower apical Drs and basal Dis. Systolic LV TMI was decreased in accordance with LV systolic dysfunction in DCM （correlation coefficient of Spearman, r = 0. 517, P = 0. 000）. Conclusions These results suggested the significant impact of LV TMI on global LV systolic function in patients with DCM. High frame-rate QTVI technique would be more useful for the evaluation the left ventricular twist in clinical application.

关 键 词：超声心动描记术 心肌病 扩张型 旋转 心室功能 左 

分 类 号：R686[医药卫生—骨科学]