三维斑点追踪技术评价正常人左心室心肌应变的初步研究  

Evaluation of left ventricular strain in healthy subjects by three-dimensional speckle tracking

作　　者：段利科[1] 李玲[1] 谢明星[1] 王新房[1] 陈玉媛[1] 李薇玢[1] 李蔚[1] 王巧[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室,武汉430022

出　　处：《中华医学超声杂志（电子版）》2010年第5期37-40,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的应用三维斑点追踪技术(3DT)和二维斑点追踪技术(2DT)评价正常人左心室心肌纵向、径向和圆周应变,探讨3DT在评价左心室心肌应变中的应用价值。方法健康志愿者32例,经胸超声同时采集左心室心尖四腔和两腔切面图像后,获取左心室三维全容积动态图像,存储图像后运用3DT分析软件进行脱机分析。经胸超声采集并存储左心室短轴二尖瓣水平、乳头肌水平和心尖水平二维图像和心尖四腔切面、两腔切面和左心室长轴切面二维图像,运用2DT分析软件脱机分析。分析并比较上述两种方法获得的左心室心肌16节段纵向、径向和圆周收缩期峰值应变值。结果 3DT测得的左心室16节段纵向应变峰值均值明显低于2DT,圆周应变峰值均值明显高于2DT(P<0.05),两种方法测得的径向应变峰值均值差异无统计学意义(P>0.05)。运用3DT时存储图像和分析图像所用时间均明显短于2DT(P<0.05),两种方法测得左心室纵向、径向和圆周平均峰值应变的观察者内和观察者间的变异系数之间差异无统计学意义(P>0.05)。结论 3DT是一种方便、快速、具有可重复性的评价左心室心肌纵向、径向和圆周应变的新方法,3DT与2DT测得左心室心肌纵向和圆周应变的不同可能由于2DT只能在平面内追踪心肌运动的局限性所致。Objective To assess left ventricular longitudinal strains （ LS）, radial strains （RS） and circumferential strains （CS） in healthy subjects by using two-dimensional speckle tracking （2DT） and three- dimensional speckle tracking（3DT） , and to investigate the feasibility of 3DT for assessment of left ventricu- lar（LV） myocardial strains. Methods The dynamic images of apical two- and four-chamber views were dis- played and apical full-volume acquisition was obtained in 32 subjects to visualize the entire LV in a volumetric imagine. The full-volume imagines were recorded and then were analyzed by off-line 3DT analysis software. The images were recorded from the left ventricular short-axis views at the levels of mitral valve, pa- pillary muscle and apex, and the four-chamber view, two-chamber view and long-axis view of left ventricle. Then these images were analyzed by off-line 2DT analysis software. The longitudinal peak systolic strains, radial peak systolic strains and circumferential peak systolic strains of left ventricle by using 3DT and 2DT were compared. Results The mean longitudinal strain of left ventrieular by 3DT was significantly smaller than by 2DT, and the mean circumferential strain by 3DT was significantly larger than by 2DT. But there was no significant difference in the mean radial strain between 3DT and 2DT. The times for acquisition and analysis of the images by 3DT were significantly shorter than by 2DT. No significant difference in the intraob- server and interobserver coefficient variation between 3DT and 2DT was observed. Conclusions The 3DT is a convenient, feasible, reproducible and new method to evaluate longitudinal, radial and circumferential strains of left ventricle. The limitation of 2DT was lack of tracking the spot out of plane, which was different from 3 DT.

关 键 词：三维超声心动描记术 左心室功能 

分 类 号：R540.4[医药卫生—心血管疾病]