超声斑点追踪成像技术对心内膜弹力纤维增生症患儿左心室短轴二维应变的研究  

Short-axis Strain of Left Ventricle in Endocardial Fibroelastosis: Quantified by Speckle Tracking Imaging

作　　者：曲冉[1] 任卫东[1] 刘爽[2] 肖杨杰[1] 孙菲菲[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004 [2]中国医科大学附属第一医院心功能科,辽宁沈阳110001

出　　处：《中国医学影像学杂志》2012年第11期842-845,共4页Chinese Journal of Medical Imaging

基　　金：辽宁省教育厅课题项目(L2010660;L2010667)

摘　　要：目的应用超声斑点追踪成像技术(STI)定量研究心内膜弹力纤维增生症(EFE)患儿左心室短轴各节段心肌的二维应变,探讨其变化规律。资料与方法 23例EFE患儿取胸骨旁左心室短轴基底段、中间段和心尖段连续5个心动周期图像(3个平面显示左心室16节段)。应用QLab8.1软件分析各短轴平面的整体应变峰值和各节段收缩期应变峰值。选择20例性别、年龄相匹配的健康体检者作为对照组。结果①EFE组心内膜增厚的部位集中在下壁(100%)、后壁(100%)、侧壁(87%),少数累及前壁(4%);②与对照组比较,EFE组左心室所有节段圆周应变峰值降低(P<0.01),11节段径向应变减低(P<0.05、P<0.01);EFE组左心室短轴3个平面整体应变明显降低(P<0.01);③EFE组内各平面下、后、侧壁心肌较其余各壁径向及圆周应变减低程度无显著差异。结论 EFE患儿心内膜增厚呈非均匀性,EFE患儿左心室短轴整体及各节段收缩期圆周应变和多数节段的径向应变明显低于正常人,提示其左心室短轴收缩功能严重受损,且心肌的收缩功能呈非均匀弥漫性减低。Purpose To quantify two-dimensional systolic strain of short axis in left ventricle （LV） in patients with endocardial fibroelastosis （EFE） using speckle tracking imaging （STI）. Materials and Methods Echocardiographic examinations were performed on 23 patients with EFE and 20 healthy subjects were recruited as controls. LV short-axis views of five consecutive cardiac cycles were obtained. QLab 8.1 was used to analyze global strains in basal, middle, and apical views, as well as systolic peak radial and circumferential strains in LV 16 segments. Results ① Thickened endocardium of EFE mostly involved the inferior wall （100%）, posterior wall （100%） and lateral wall （87%）, with little chance to involve anterior wall （4%）. ② Compared with the controls, peak of all segments of LV circumferential strain （P0.01） and systolic peak radial strain in 11 of 16 segments （P0.05, P0.01） significantly reduced in EFE group. Overall strain in all three planes of short axis of LV also significantly reduced （P0.01）. ③ There was no significant difference of systolic peak radial and circumferential strains between the inferior, posterior and lateral segments and other segments in the same view. Conclusion Endocardial thickening of EFE children is non-uniformly where LV global strain, systolic peak circumferential strain in all segments and systolic peak radical strain in 11 of 16 segments significantly reduced in EFE children when compared with normal children, which indicates systolic function of LV short-axis in EFE children is severely impaired with non-uniformly diffuse reduction.

关 键 词：心内膜弹力纤维增生症 超声心动描记术 多普勒 彩色 斑点追踪成像 心室功能 左 

分 类 号：R725.4[医药卫生—儿科] R445.1[医药卫生—临床医学]