二维应变和应变率成像技术监测心脏移植术后急性排异反应  

Two-dimentional strain/strain rate imaging assessment of acute rejection after heart transplantation

作　　者：何怡华[1] 李治安[1] 谷孝艳[1] Nixon J V(Ian) 

机构地区：[1]首都医科大学附属北京安贞医院超声诊断科,北京100029 [2]弗吉尼亚联邦大学心脏内科,里士满23298

出　　处：《中国医学影像技术》2009年第7期1179-1182,共4页Chinese Journal of Medical Imaging Technology

基　　金：北京市优秀人才基金(2005ID0300619)

摘　　要：目的探讨超声心动图二维应变和应变率成像技术在监测心脏移植术后急性排异反应方面的价值。方法对25例心脏移植患者在活检12h内行超声心动图检查。急性排异反应0级为A组(n=10),急性排异反应Ⅰa～Ⅰb级为B组(n=8),急性排异反应≥Ⅱ级为C组(n=7)。正常对照组为D组(n=30)。应用二维应变和应变率成像测量收缩期各室壁纵向、径向及环向应变及应变率。对各数据进行组间比较,并进行统计学分析。结果二维应变应变率分析:A、B、C组与D组比较:室间隔基底段收缩期纵向应变、二尖瓣水平前间隔环向应变率、二尖瓣水平所有节段的径向应变均明显减低(P<0.05)。结论二维应变和应变率成像技术的径向应变能早期、敏感地反映出≥Ⅱ级心脏移植急性排异反应患者的心脏收缩功能变化,可以作为心脏移植术后急性排异反应的筛查指标。Objective To assess the value of two-dimentional strain/strain rate （2D-S/SR） imaging compared with endomyocardial biopsy （EMB） in detecting acute rejection （AR） reaction after heart transplantation （HT）. Methods Twenty-five patients who required HT underwent echocardiography within 12 h after EMB. Ten patients of grade 0 AR were regarded as group A, 8 patients with grades Ⅰa-Ⅰb were considered as group B, 7 patients with grades≥Ⅱa were considered as group C. Thirty age-matched normal controls were considered as group D. The longitudinal, radial and circumferential stain and strain rate of different ventricular wall in systolic were measured and compared among groups. Results Compared with the group D, longitudinal stain （LS） of basal-septum, circumferential strain rate （CSR） of ant-septum at the level of mitral valve, radial strain （RS） of all segments at the level of mitral valve reduced in groups A, B and C. Conclusion The RS of 2D-S/SR is an effective and sensitive technique for the detection of acute rejection, and longitudinal stain can be used as an early index of AR for grade ≥Ⅱ after HT.

关 键 词：超声心动描记术 应变 应变率 心脏移植 急性排异反应 

分 类 号：R392.4[医药卫生—免疫学] R540.45[医药卫生—基础医学]