二维斑点追踪与双源CT分析左心室前壁缺血的局部心肌功能  

Local Myocardial Function of the Anterior Wall Ischemia of the Left Ventricle Evaluated by Using Two-dimensional Speckle-tracking Echocardiography and Dual-source CT

作　　者：郑东燕[1] 陈明[1] 张宇辉[1] 张蕾[1] 郑建华[1] 刘怡[1] 

机构地区：[1]同济大学医学院附属东方医院心脏医学部,上海200120

出　　处：《中国医学影像学杂志》2012年第11期862-865,共4页Chinese Journal of Medical Imaging

基　　金：浦东新区科技发展基金创新资金项目(PKJ2010-Y16);上海市卫生局青年基金项目(2010Y012);上海市浦东新区心血管疾病学科群项目(PWZxkq2010-01);上海市卫生局卫生科技面上项目(2009158)

摘　　要：目的运用斑点成像技术结合二维超声多点取样采集部分左心室前壁心肌,结合双源CT显示左心室前壁心肌额断面,评估左心室前壁缺血患者左心室前壁心肌运动功能。资料与方法左心室前壁缺血(实验组)及无左心室前壁缺血(对照组)各20例患者,采用二维超声及双源CT在左心室前壁心肌额断面采集25个感兴趣区,计算感兴趣区在各左心室心肌节段所占百分比。采用双源CT测定两组患者室壁增厚度及室壁移动幅度的变化。分析收缩期应变、收缩期应变率与室壁增厚度、室壁移动幅度的相关性。结果应用双源CT在左心室前壁心肌额断面上采集到的感兴趣区分别对应于左心室牛眼图的第1节段(占28.31%)、第7节段(占47.38%)和第13节段(占24.31%);实验组左心室前壁室壁增厚度及室壁移动幅度均较对照组明显减低(P<0.05);左心室前壁心肌应变、应变率室壁增厚度、室壁移动幅度均呈明显正相关(r=0.852、0.843、0.726、0.770,P<0.001)。结论二维超声与双源CT的左心室前壁额断面法均能显示左心室前壁心肌,且多点取样斑点成像参数结合双源CT可用于临床评估左心室前壁缺血患者的左心室前壁局部心肌运动功能。Purpose To evaluate myocardial function of the anterior wall (AW) of left ventricle (LV) by using multiple sampling two-dimension speckle-tracking echocardiography (STE) and dual-source CT in patients with myocardial ischemia. Materials and Methods Patients with or without myocardial ischemia in the AW of LV were recruited (n=20 for each group). Twenty-five regions of interest (ROI) in the AW were obtained and tracked by STE and by dual-source CT. Percentage of ROI in the segment of the left ventricular myocardial was calculated. Wall thickness (WT) and wall motion (WM) were measured by dual-source CT. The relationship between the data generated by STE and dual-source CT were analyzed. Results 28.31% of ROI obtained by dual-source CT were located at the first segment, 47.38% of them at the seventh segment and 24.31% of them at the thirteenth segment. WT and WM of the AW significantly decreased in the group of ischemia (P<0.05). There were positive correlations between parameters of STE (ε and SRS) and data obtained from dual-source CT (r=0.852, 0.843, 0.726, 0.770, P<0.001). Conclusion Coronal section of TDE and dual-source CT can provide an alternative view for imaging AW of LV. Multiple ROIs of STE and dual-source CT can provide an alternative option to evaluate the anterior wall motion in patients with myocardial ischemia.

关 键 词：心肌缺血 超声心动图描记术 斑点追踪成像 体层摄影术 X 线计算机 心室功能 左 

分 类 号：R543.3[医药卫生—心血管疾病] R445.1[医药卫生—内科学]