犬左心室局部心肌构筑和旋转运动力学机制关联性的超声初步研究  

A primary study on the relationship between regionalmyocardial architecture and mechanics of rotation motion in beagle canine left ventricle with high-frequency ultrasonic and speckle tracking imaging

作　　者：傅英[1] 龙滨[3] 陆景[2] 李文华[2] 李朝军[4] 李春梅[2] 邓燕[2] 庄丁 罗安果[2] 苏莉[2] 尹立雪[2] 

机构地区：[1]四川省犍为县人民医院功能科,四川乐山614400 [2]四川省医学科学院·四川省人民医院超声医学研究所,超声心脏电生理学与生物力学四川省重点实验室,四川成都610072 [3]解放军452医院特诊科,四川成都610021 [4]百胜深圳医疗设备有限公司,广东深圳518057

出　　处：《实用医院临床杂志》2012年第5期38-45,共8页Practical Journal of Clinical Medicine

摘　　要：目的应用高频超声结合二维斑点跟踪成像技术对犬生理状态下左心室前壁局部心肌旋转运动进行力学分析,结合病理技术,探讨局部心肌旋转运动力学状态与心外膜下心肌构筑的时域变化特点。方法 8只健康比格犬开胸模型,随机分为收缩末期和舒张末期两组,每组4只,使用高频超声仪采集左心室前壁局部标记点(H、M、L三水平共六点)短轴切面连续三个心动周期二维超声灰阶图像并存盘,脱机应用二维斑点跟踪成像技术软件分析标记点心肌旋转运动力学状态,对同一水平左右两标记点处心外膜下心肌单心动周期内10等分点处心肌旋转位移值组间均数趋势对比分析。实验结束后,分别用10.0%KCl和32.5%的BaCl2溶液处死两组实验犬,令其心肌停留于收缩末期和舒张末期,6%甲醛溶液固定,制作组织切片和病理切片,显微镜下观察并摄影存图;采用球形检验、多元方差分析、单因素方差分析方法进行统计分析。结果①二维灰阶超声观察:同一水平左右两标记点处心外膜下心肌片层结构在同一心动周期内存在围绕左心室中心点的旋转运动,同时也存在相对的自转运动;靠近基底H水平运动呈反向,靠近心尖L水平则大部分呈同向;收缩期大部分呈长轴观,舒张期大部分呈短轴观,均呈反向旋转。②组织病理切片观察:收缩末期组:心外膜下心肌增厚,H、M水平左右两标记点心肌纤维多呈长轴观,左右侧心肌片层大部分反向排列;L水平两侧标记点方向较一致,且多向右排列;舒张末期组:心外膜下心肌变薄,H、M、L水平左右两标记点处心肌纤维多呈短轴观,排列方向基本一致。③组间均数趋势观察:H、M水平左右两标记点处收缩早期和舒张末期心肌旋转方向较一致,收缩中晚期及舒张早中期呈反向旋转,左侧为逆时针方向,右侧为顺时针方向,左侧逆时针旋转位移幅度向心尖方向逐渐增加,右侧顺�Objective To analyze mechanics of rotational motion of left ventricle regional myocardium using high-frequency ultrasound combined with speckle tracking imaging under pathological conditions. Together with pathological techniques, the objective of study was to understand status of mechanics of regional myocardial rotational motion and characteristics of myocardial architecture changes. Methods Eight open-chest healthy female beagle canine models were randomly divided into systolic and diastolic groups of 4 of each. Total of 6 markers at three levels （H,L and M） were marked on regional epicardium of left ventricular anterior wall. Each level had two markers with interval of 1.0 cm. The motion of marked myocardium was observed with high-frequency ultrasound. Uhrasonograms of cross section along markers of three successive cardiac cycles in baseline state were saved. The status of mechanics of regional myocardial rotational motion was off-line analyzed with Olab 7.0 MVQ soft. The animals were executed for euthanasia with 10% KCl so- lution or 32.5 % BaCI2 solution after echocardiographic image collection,which can keep myocardium at end diastole or end systole. The heart were isolated and fixed in 6% formaldehyde solution for patho-histological examination. Finally, all data were statistically analyzed. Results ①Two-dimensional gray ultrasonic images showed that there was rotary motion of myocardium around center point of left ventricle during each cardiac cycle. Orientations of the rotary motion were different from systolic stage to diastolic stage. The observations were confirmed by patho-histological examinations. ②There was no significant difference in myocardium rotary displace- ment between systolic early stage and diastolic late stage. However, the displacements were significant different between systolic metaphase or late stages and diastolic pro-or meta-phase （P 〈 0.01 or P 〈 0.05, respectively）. Moreover, the measurements by two individual operators was highly correlated （ r 〉 0.6, P �

关 键 词：超声心动图 高频超声 旋转 心肌构筑 左心室 运动力学 

分 类 号：R540.45[医药卫生—心血管疾病] R322.11[医药卫生—内科学]