实时三维超声心动图评价扩张型心肌病患者左心室同步性  

Evaluation of left ventricular dyssynchrony on dilated cardiomyopathy patients by real-time three-dimensional echocardiography

作　　者：姜凤霞[1] 郭瑞强[1] 陈金玲[1] 周青[1] 郝力丹[1] 初洪刚[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2011年第5期378-381,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨实时三维超声心动图（RT-3DE）评价扩张型心肌病（DCM）患者左室机械运动同步性的应用价值。方法采集28例DCM患者（DCM组）和29例正常人（对照组）实时三维全容积图像。由左室17节段容积一时间曲线测量各节段从心电图Q波起始点至收缩期最小容积时间（Tmsv），分别计算各组内1—17节段达收缩期最小容积的平均时间（Tmsv’）。推算左室3个短轴水平（基底水平、乳头肌水平和心尖水平）、12节段和16节段的同步性参数，同步性参数包括达收缩期最小容积时间标准差（Tmsv1-6-SD，Tmsv7—12-SD，Tmsv13—16-SD，Tmsv12-SD，Tmsv16-SD）和最大时间差（Tmsv1-6-Dif，Tmsv7—12-Dif，Tmsv13-16-DIF，Tmsv12-Dif，Tmsv16-Dif）。结果对照组与DCM组分别进行组内17节段Tmsv’比较，差异均无统计学意义（P=1）。DCM组左室各节段Tmsv’与对照组相应节段比较，差异均无统计学意义（P〉0．05）。与对照组比较，DCM组左室各水平、12节段和16节段同步性参数均显著增高，除乳头肌水平同步性参数外（r=-0．402—0．449，P〉0．05），其余均与RT-3DE所测左室射血分数呈显著线性负相关（r=-0．576～-0．768，P〈0．01或P〈0．05）。结论DCM患者左室整体及各短轴水平内均存在机械运动不同步，RT-3DE可对其进行定量评价。Objective To evaluate the left ventricular synchronicity in patients with dilated cardiomyopathy （DCM） by real-time three-dimensional echocardiography （RT-3DE）. Methods Twentyeight DCM patients and twenty-nine healthy volunteers were enrolled in this study, and clear full volume pictures were aquired using RT-3DE. The time to minimal systolic volume （Tmsv） of each segment was measured,and a mean value of Tmsv for the same segment in each group （Tmsv＇） was caculated. The standard deviation （Tmsv-SD） and the maximal difference （Tmsv-Dif） of Tmsv were calculated for basal level,mid level, apical lever, 12 segments and 16 segments （Tmsvl-6-SD, Tmsv7-12-SD, Tmsv13-16-SD, Tmsv12-SD, Tmsv16-SD, Tmsv1-6-Dif , Tmsv7-12-Dif , Tmsv13-16-Dif , Tmsv12-Dif , Tmsv16-Dif）. Results There were no significant differences among 1-17 Tmsv＇ within each group. No significant differences were found between two groups for Tmsv＇ derived from the same segment. All asynchrony indexs of DCM patients were remarkably higher than those of the healthy volunteers （ P 〈 0.01 or P 〈 0.05）, and correlated closely with LVEF determined by RT-3DE （ r = -0. 576- -0. 768, P 〈0.01 or P 〈0.05） except for those of the mid level（ r = - 0. 402- - 0.449, P 〉0.05）. Conclusions Dyssynchrony exist in globle and each level of DCM patients＇ left ventricle. RT-3DE is an available technique for left ventricular synchronicity quantification.

关 键 词：超声心动图描记术 实时三维 心肌病 扩张型 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学]