四种多普勒成像技术在冠状动脉狭窄与病变心肌检测中的价值  

Quantitative study on left ventricular myocardial movement in coronary heart disease using four Doppler imaging techniques

作　　者：张生光[1] 俞静[1] 汪荣金[1] 陈爱[1] 骆合德[2] 

机构地区：[1]中国人民解放军第98医院特诊科,湖州313000 [2]中国人民解放军第98医院心内科,湖州313000

出　　处：《浙江医学》2008年第2期132-135,F0003,共5页Zhejiang Medical Journal

摘　　要：目的探讨左室局部心肌收缩和舒张速度、形变、位移及同步性变化与冠状动脉狭窄程度的关系。方法应用定量组织速度成像(QTVI)、应变率成像(SRI)、组织追踪(TT)和组织同步化成像(TSI)定量分析19例冠状动脉粥样硬化性心脏病(简称冠心病)患者和21名正常人左室局部心肌收缩期(Vs)、舒张早期(Ve)和舒张晚期峰值速度(Va);收缩末期(εsys)、峰值(εp)和收缩后应变(εps)及R波至峰值应变的时间(T-εp);收缩期(SRs)、等容舒张期(SRir)、舒张早期(SRe)及舒张晚期应变率(SRa);收缩期峰值位移(Ds)、R波至收缩期位移峰值的时间(T-ds)及收缩达峰时间(Ts)等指标。结果在中重度狭窄者中SRs(-0.79±0.69)s-1、SRir(-0.34±0.87)s-1、SRe(0.51±0.64)s-1及Vs(3.79±1.66)cm/s、Ve(-4.58±1.85)cm/s、Ds(7.84±2.94)cm/s较对照组SRs(-1.02±0.53)s-1、SRir(0.067±0.53)s-1、SRe(1.13±0.62)s-1及Vs(5.50±1.79)cm/s、Ve(-6.50±2.86)cm/s、Ds(9.99±3.07)cm/s降低,差异有统计学意义(均P<0.05);εps(-5.38±6.89)%、T-ds(421.76±56.63)ms和T-εp(512.43±124.59)ms较对照组εps(-1.59±2.80)%、T-ds(351.46±44.96)ms、T-εp(363.41±71.58)ms明显增加,差异有统计学意义(P<0.05或P<0.01)。结论QTVI、SRI和TT均能较准确地检出中重度冠状动脉狭窄患者静息状态下的异常心肌节段。Objective To observe the relationship between the left ventricular myocardial movement in coronary heart disease and the degree of stenosis in coronary artery with 4 Doppler imaging techniques. Methods Twenty-one normal subjects （control group） and 19 cases （stenotic group） with coronary heart disease verified by coronary arteriography were examined by quantitative tissue velocity imaging （QTVI）,strain and strain rate imaging （SRI）,tissue tracking （TT） and tissue synchronicity imaging （TSI）. Twelve left ventricular segments were analyzed,14 indices were obtained and compared between the two groups,including velocity at systole （Vs）,early diastole （Ve）,artrial contraction （Va）,peak strain （εp）,end-systolic strain （ε sys ）,postsystolic strain （ε ps）,time from R wave to peak strain （T-εp） , the strain rate at systole （SRs）, isovolumic relaxation （SRir）, early diastole （SRe）, atrial contraction （SRa）, displacement at systole （Ds）,time from R wave to peak displacement （T-ds） and systolic time to peak （Ts）. Results Compared with the control group,SRs,SRir,SRe,Vs,Ve,Ds were decreased and ε ps,T-ds,T-εp were significantly increased in the moderate and severe-stenosis group （ P〈0.05 and P〈0.01,respectively）. Conclusion QTVI,SRI and TT can detect the abnormal segments in patients with moderate or severe coronary artery stenosis at rest.

关 键 词：定量组织速度成像 应变率成像 组织追踪 组织同步化成像 冠状动脉狭窄 冠状动脉造影 

分 类 号：R543[医药卫生—心血管疾病]