定量组织速度成像心肌速度梯度评价胸部放疗患者左心室心肌局部舒张功能的研究  

Quantitative tissue velocity imaging myocardial velocity gradient in assessment of left ventricular diastolic function in patients with thoracic radiotherapy

作　　者：张连仲[1] 张娜[1] 刘琳[1] 吴晓翠[1] 韩倩[1] 王跃伟[1] 王文玉[1] 牛波[1] 

机构地区：[1]河南省人民医院,河南郑州450003

出　　处：《中国临床医学影像杂志》2008年第8期566-569,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨定量组织速度成像(QTVI)心肌速度梯度技术在评价胸部放疗患者左室局部舒张功能方面的临床应用价值。方法:应用QTVI技术离线分析40例胸部肿瘤放疗患者和20例正常人左心室各心肌节段长轴和短轴方向上的速度曲线,并将40例胸部肿瘤放疗患者按照放疗进程分为二组:A组:2.7～3.3周、照射剂量30～40Gy;B组:4.1～5.5周、照射剂量50～60Gy;测量舒张早期峰值速度(Ve)和舒张晚期峰值速度(Va),并计算长轴和短轴方向上舒张早期及晚期心肌速度梯度MVG1、MVG2和MVG3等参数。结果:①A组和B组左室二尖瓣口血流速率(E/A)比值较对照组减低(P<0.05);B组的E/A比值较A组减低(P<0.05)。②A组和B组前壁、前间隔、后壁各节段MVG1、MVG2及MVG3均较对照组明显减低(P<0.05);B组前壁、前间隔、后壁各节段MVG1、MVG2及MVG3较A组减低(P<0.05);A组和B组侧壁、后间隔各节段MVG1、MVG2及MVG3较对照组略减低但差异无显著性(P>0.05);下壁各节段MVG1、MVG2及MVG3在3组之间比较,差异均无显著性(P>0.05)。结论:胸部放疗患者左心室长轴和短轴方向局部心肌舒张功能存在一定程度的降低;心肌速度梯度可以对其进行正确评价,为局部心肌舒张功能的估测提供了一个新的量化指标。Objective： To evaluate the clinic experimental value of quantitative tissue velocity imaging （QTVI） in assessing left ventricular diastolic function in patients who had thoracic radiotherapy. Methods： There were 40 patients with thoracic radiotherapy and 20 healthy controls in this study. Myocardial velocity gradient （MVG） and conventional echocardiographic parameters were performed in 60 subjects. According to the process of radiotherapy, the 40 patients were divided into two groups： group A： radiotherapy time was 2.7-3.3 weeks, radiotherapy dose was 30-40Gy; group B： radiotherapy time was 4.1- 5.5 weeks, radiotherapy dose was 50-60Gy. Off line profiles of the left ventricular regional diastolic velocity along long axis in the 40 patients and 20 healthy subjects were analyzed by QTVI. Regional diastolic velocities （Ve, Va） were measured at each segment of left ventricular basal, middle and apical levels. MVG were calculated respectively. Results：①Left ventricular inflow velocity index （E/A） of group A and group B was significantly lower than that in the control group （P〈0.05）; There was significant difference of E/A ratio between group B and group A （P〈0.05）. ②MVG1, MVG2 and MVG3 of group A and group B in anterior wall, anterior septal, posterior wall were significantly lower than those in the control group （P〈0.05）; MVG1, MVG2 and MVG3 of group B in anterior wall, anterior septal, posterior wall were lower than those in group A （P〈0.05）; MVG1, MVG2 and MVG3 of group A and group B in left lateral wall, posterior wall, septal wall were lower than those in the control group（P〉0.05）; MVG1, MVG2 and MVG3 of inferior and posterior walls in all groups had no significant difference （P〉0.05）. Conclusion： The results in this study demonstrated that regional left ventricular diastolic function was decreased in patients with thoracic radiotherapy. MVG derived from myocardial QTVI could assess left ventricular diastolic function correctly, which could off

关 键 词：心肌 超声心动描记术 

分 类 号：R331.31[医药卫生—人体生理学] R445.1[医药卫生—基础医学]