实时三维超声心动图与组织多普勒速度成像评价左室收缩不同步的一致性研究  

Consistency Study of Real Time Three-dimensional Echocardiography and Tissue Doppler Velocity Imaging in Assessment of Left Ventricular Systolic Asynchrony

作　　者：李爱莉[1] 柯元南[1] 叶小钧[1] 姜红[1] 王晓莉[1] 王云[1] 陈馨[1] 

机构地区：[1]卫生部中日友好医院心内科超声心动图室,北京市100029

出　　处：《中国超声医学杂志》2008年第5期418-421,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨实时三维超声心动图在评价左室收缩不同步方面的临床应用价值。方法对22例慢性心力衰竭(心衰)患者和30例无心脏疾病患者同时进行组织多普勒和实时三维同步化分析。选取组织多普勒测定的左室12节段收缩期速度达峰时间标准差(Ts-SD)和最大时差(Ts-Dif)、三维测定的左室12节段收缩期容积达峰时间标准差(Tmsv-SD)和最大时差(Tmsv-Dif)作为左室内不同步指标。以对照组各测定指标的均值+2.3标准差为单侧99%上限值。心衰组各测定指标大于该值判定为存在左室内不同步。将2种方法评价心衰组左室不同步的结果进行比较(χ2检验、Kappa检验)。结果Tmsv-SD与Ts-SD、Tmsv-Dif与Ts-Dif对心衰组左室不同步的检出率无显著性差异(P值分别为0.250、0.500),检测左室不同步有较好的一致性(Kappa值分别为0.73、0.81)。结论实时三维超声心动图测定的Tmsv-SD和Tmsv-Dif可作为临床评价左室心肌收缩不同步的有效指标。Objective To evaluate the clinical value of real time three-dimensional echocardiography （3DE） in assessment of left ventricular （LV） systolic asynchrony by consistency study with tissue Doppler velocity imaging （TDI） . Methods We studied 22 patients with chronic heart failure （HF group） and 30 normal subjects matched by age and gender （control group）.TDI and 3DE synchrony analysis was done for all subjects. The time to peak systolic velocity （Ts） of LV in 12 segments were measured and its standard deviation （Ts-SD） and maximal difference （Ts-Dif） were calculated. The time to the point of minimal systolic volume （Tmsv） and its standard deviation （Tmsv-SD） and maximal difference （Tmsv-Dif） were acquired automatically by 3DE analysis. We selected Ts-SD, Ts-Dif on TDI and Tmsv-SD, Tmsv-Dif on 3DE as systolic asynchrony parameters. The ＂meanA-2.3SD＂ value in the control group was defined as the normal upper limit which represents 99% of the control group distribution. Any values above this limit in HF patients were considered statistically different from those in the control group and were accordingly classified as LV asynchrony. The results of these two methods were analyzed by McNemar test and Kappa test. Results No significant difference and good consistency were found between Tmsv-SD and Ts-SD, Tmsv- Dif and Ts-Dif in detecting LV systolic asynchrony in HF group （P： 0.250, 0.500 Kappa = 0.73, 0.81, respectively） .Conclusions Tmsv-SD and Tmsv-Dif of 3DE have good consistency with Ts-SD and Ts-Dif of TDI and may be the potential useful parameters for assessing LV systolic asynchrony.

关 键 词：超声心动图 实时三维 组织多普勒速度成像 左室收缩不同步 

分 类 号：R445.1[医药卫生—影像医学与核医学]