斑点追踪显像评价犬心肌缺血-再灌注后存活心肌的价值  

Assessment of Segmental Myocardial Viability After Ischemia-reperfusion in Dogs Using Speckle Tracking Imaging

作　　者：喻晓娜[1] 郭亚军[1] 白洋[2] 王欣[1] 杨军[2] 任卫东[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12期913-916,共4页Chinese Journal of Medical Imaging

基　　金：辽宁省自然科学基金项目(20092134)

摘　　要：目的探讨犬缺血-再灌注模型中斑点追踪超声心动图检查存活心肌的价值。材料与方法健康犬14只,开胸后阻断左冠状动脉前降支构建心肌缺血-再灌注模型(缺血3h,再灌注1h),于再灌注1h采集左心室中部切面短轴二维图像,处死犬后行氯化三苯基四氮唑(TTC)染色。随机测量84个节段收缩末期的径向应变和圆周应变,根据TTC染色结果,比较梗死面积≤50%及>50%节段的径向应变和圆周应变。结果与≤50%梗死面积或无梗死节段相比,梗死面积>50%的节段,其收缩末期径向应变和圆周应变减低(P<0.05)。收缩末期径向应变≥9.72%,判定心肌存活的敏感度为77%,特异度为84%;圆周应变≤-4.92%,判定心肌存活的敏感度为90%,特异度为94%,两者判断心肌存活的优劣性差异无统计学意义(P>0.05),但圆周应变有更大的曲线下面积。结论二维应变超声心动图能够检测心肌功能障碍,评价心肌存活性;收缩末期径向应变与圆周应变均为可靠指标。Purpose To investigate speckle tracking imaging （STI） in distinguishing viable myocardium from infarction in a dog ischemia-reperfusion model. Materials and Methods Fourteen healthy dogs underwent left anterior descending coronary artery occlusion for three hours followed by one hour reperfusion. Short-axis STI was performed in the mid-ventricle one hour post reperfusion. Triphenyl tetrazolium chloride （TTC） stain was used postsacrifice. Regional end-systolic radial and circumferential strain were measured using software in all 84 segments with areas of infarct in corresponding histological slices. Results The extent of infarct correlates with radial and circumferential strain. The larger inthrct size, the smaller radial and circumferential strain. Segments with greater than 50% area of infarct had lower end-systolic radial and circumferential strain compared with areas with 〈50% or no infarct. End-systolic radial strain greater than 9.72% had 77% sensitivity and 84% specificity for detecting viable area greater than 50%. End-systolic circumferential strain less than --4.92% had 90% sensitivity and 94% specificity for detecting viable area greater than 50%. There was no significant difference between radial and circumferential strain for myocardial viability assessment. However, circumferential strain had a greater area under the ROC curve. Conclusion In addition to detecting myocardial dysfunction, strain measurements are helpful in the assessment of myocardial viability. End-systolic radial and circumferential strain may be reliable indicators.

关 键 词：心肌缺血 心肌再灌注损伤 超声心动描记术 斑点追踪显像 疾病模型 动物 狗 

分 类 号：R-332[医药卫生] R445.1