二维斑点追踪成像与定量组织速度成像评价心功能不全患者左室扭转运动  

Left ventricular twist in patients with cardiac insufficiency by two-dimensional speckle tracking and quantitative tissue velocity imaging

作　　者：解欣欣[1] 郑慧[1] 张婧姝[1] 靳鹏[1] 帅秀芳[1] 姚文[1] 张昊[1] 

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022

出　　处：《安徽医科大学学报》2012年第9期1098-1102,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校自然科学基金重点项目(编号:NOKJ2010A175)

摘　　要：目的应用二维斑点追踪成像(2D-STI)与定量组织速度成像(QTVI)技术评价心功能不全患者左室扭转运动特征,对比分析两种方法在评价心功能不全中的应用价值。方法收集30例心功能不全患者(心功能不全组)和30例健康志愿者(正常对照组)的左室心底水平(MV)及心尖水平(AP)标准短轴图像。应用2D-STI测量各水平峰值旋转角度(Pr)、收缩末峰值旋转角度(AVC-r),计算左室扭转角度(LVtw)、收缩末左室扭转角度(AVC-LVtw)。应用QTVI测量各水平侧壁及后间隔切线方向运动速度,并得出该水平收缩期侧壁间隔位移差(SDl-s),计算左室扭转运动指数(TMI)。由同一观察者于不同时间反复测量上述参数,计算两种方法的观察者内变异系数。结果①正常对照组的收缩期旋转及扭转运动特征:从心尖向心底方向观察,MV顺时针旋转,AP逆时针旋转,左室逆时针扭转,LVtw为(14.57±3.06)°,TMI为11.80±1.16;②心功能不全组MV旋转方向与正常对照组一致,部分病例AP旋转方向及左室扭转方向发生变化。心功能不全组Pr、LVtw、SDl-s及TMI均明显减低,差异有统计学意义(P<0.05);③2D-STI技术在评价心功能不全方面较为稳定可靠,QTVI较为简捷直观。结论 2D-STI与QTVI技术均可用于评价心功能不全患者的左室旋转及扭转运动,2D-STI较为稳定可靠,QTVI较为简捷直观。Objective To evaluate the characteristics of left ventricular twist in patients with cardiac insufficiency by using two-dimensional speckle tracking imaging and quantitative tissue velocity imaging, and to identify the application of the two methods. Methods We selected standard dynamic images of basal and apical-LV short-axis from thirty patients with cardiac insufficiency and thirty healthy volunteers. Basal and apical peak value of left ventricular rotation（ Pr） and the value of left ventricular rotation at the end of systole（AVC-r） were measured by the software of two-dimensional speckle tracking imaging, then the angles of left ventricular twist （ LV,w ） and twist at the end of systole（ AVC-LVtw ） were calculated. The velocities of lateral wall and septum were measured by the software of Q-anlysis, then the systolic lateral-septal maximum displacement difference and torsional motility index were obtained. The process of the parameters was repeated by the same person to calculate the index of interobserver variabilities. Results （1） The characteristics of left ventricular twist of control group ： As seen from the apex, the LV performed a wringing motion with a clockwise rotation at the base and a counterclockwise rotation at the apex during the systole. The whole heart peformed a motion with counterclockwise twist. The angle of twist was （ 14.57 ＋- 3.06） °, the TMI was 11.80 ＋- 1.16. （2） Compared with healthy volunteers,there were some differences in apex rotation and twist, furthermore, MV-Pr, AP-Pr, LV-tw, MV-SDl-s, AP-SDl-s and TMI significantly decreased in pa- tients with cardiac insufficiency（P 〈 0.05 ）. （3） 2D-STI was more reliable in evaluating cardiac insufficiency, while QTVI was simple and convenient. Conclusion Both 2D-STI and QTVI can apply to the evaluation of the rotation and twist for patients who have cardiac insufficiency; 2D-STI is more reliable;QTVI is simple and convenient.

关 键 词：超声心动图 二维斑点追踪成像 定量组织速度成像 心功能不全 扭转 

分 类 号：R445.1[医药卫生—影像医学与核医学]