二维斑点追踪技术测量二尖瓣环位移:评价左心室整体收缩功能的新方法  

Detection of mitral annulus displacement with speckle tracking imaging:a new technique for evaluation of global systolic function of left ventricle

作　　者：王建华[1] 刘昕[1] 巩晓红[1] 

机构地区：[1]北京军区总医院超声科,北京100700

出　　处：《中国医学影像技术》2009年第9期1604-1607,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用超声二维斑点追踪技术(STI)获取二尖瓣环位移(MAD),探讨MAD作为评价左心室整体收缩功能指标的可行性和准确性。方法选择36名健康志愿者,获取标准心尖四腔、两腔和心尖长轴切面以及瓣环、乳头肌和心尖部左心室短轴切面,输入Qlab6.0工作站计算二尖瓣环中点处最大位移、左心室收缩期纵向应变(GLs)、圆周应变(GCs)、径向应变(GRs)和左心室扭转(LVtw)参数,应用实时三维超声心动图计算左心室射血分数(LVEF),分析左心室应变和扭转参数、MDA及LVEF之间的关系。结果①MAD与LVEF显著相关(r=0.84,P<0.01),直线回归方程为LVEF=39.05+1.88MAD;②LVEF与GLs、GRs、GCs及LVtw均显著相关,r值分别为-0.75、0.52、-0.51和0.61(P<0.01),多元回归分析提示GLs、GCs为LVEF的独立预测因子,beta值分别为-0.66、-0.35;③MAD与GLs、GRs、LVtw显著相关,r值分别为-0.73、0.47和0.46(P<0.01),MAD与GCs的相关性较差,r值为-0.35(P<0.05);GLs是MAD独立预测因子。结论MAD和LVEF之间存在良好的相关性,有望成为临床常规评价左心室整体收缩功能的一种快捷、准确的新方法。Objective To observe the feasibility and the accuracy of mitral annulus displacement（MAD） measured with speckle tracking imaging（STI） for evaluating the global function of the left ventricle.Methods The global peak systolic longitudinal strain（GLs）,circumferential strain（GCs）,radial strain（GRs） and the left ventricular twist（LVtw） of 36 healthy subjects were obtained with STI using a Qlab 6.0 workstation.The left ventricular ejection fraction（LVEF） was calculated based on real time three-dimension echocardiography.The correlation between MAD,LVEF,GLs,GCs,GRs and LVtw was analyzed respectively.Results ①Excellent correlation was found between MAD and LVEF（r=0.84,P〈0.01）.②LVEF was correlated with GLs,GRs,GCs and LVtw significantly（r=—0.75,0.52,—0.51 and 0.61,respectively,all P〈0.01）.Multi-variant regression analysis indicated that GLs and GCs were the independent predictors of LVEF（β=-0.66,-0.35,respectively）.③Optimal correlation was found between MAD and GLs,MAD and GRs,MAD and LVtw（r=—0.73,0.47 and 0.46,respectively,all P〈0.01）,and MAD was negatively correlated with GCs（r=—0.35,P〈0.05）.GLs was the independent predictor of MAD.Conclusion MAD has good correlation with LVEF and may become a new promising modality to evaluate the global systolic function of left ventricle simply and accurately.

关 键 词：斑点追踪显像 二尖瓣环位移 应变 扭转 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R33[医药卫生—诊断学]