二维斑点追踪成像和实时三维超声心动图评价二尖瓣成形术后左心房功能  

Assessment of Left Atrial Function Using Two-dimensional Speckle Tracking Imaging and Realtime Three-dimensional Echocardiography in Patients with Postoperative Mitral Valvuloplasty

作　　者：龚明霞[1] 徐敏[1] 张晓膺[2] 钱永祥[2] 

机构地区：[1]常州市第一人民医院心超室,江苏常州213003 [2]常州市第一人民医院心胸外科,江苏常州213003

出　　处：《中国医学影像学杂志》2013年第3期201-205,共5页Chinese Journal of Medical Imaging

摘　　要：目的应用二维斑点追踪成像(STI)和实时三维超声心动图(RT3DE)评价二尖瓣成形术后左心房功能,以判断手术疗效。资料与方法41例拟行二尖瓣成形术患者(成形组)于术前、术后1周及6个月分别采集二维及三维图像,测量左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心房收缩前容积(LAVpreA),计算左心房整体射血分数(LAEF)、被动排空分数(LAEFpassive)、主动射血分数(LAEFactive);应用STI技术测量左心房前壁、后壁、侧壁、下壁、房间隔的应变率,计算各平均值。选择同期25例健康志愿者作对照。结果成形组术前STI获得的左心房平均收缩前峰值应变率(mSRS)、舒张早期峰值应变率(mSRE)、舒张晚期峰值应变率(mSRA)均较对照组下降(P<0.05),术后mSRS、mSRE较术前明显升高(P<0.01),mSRA略有升高(P>0.05)。成形组术前左心房LAVmax、LAVmin、LAVpreA均较对照组增高(P<0.01),成形术后左心房各容积均明显缩小(P<0.05);术后LAEF及LAEFpassive均显著提高(P<0.01)。成形组术前、术后1周及术后6个月mSRE与LAEFpassive、mSRA与LAEFactive均呈显著正相关(r=0.957、0.787,r=0.993、0.806,r=0.992、0.723;P<0.01)。结论 STI和RT3DE均能定量评价左心房功能变化,对评估二尖瓣成形术后的疗效有一定价值。Purpose To assess the left atrial function of patients with postoperative mitral valvuloplasty by using two-dimensional speckle tracking imaging （2D-STI） and real-time three-dimensional echocardiography （RT3DTL and to determine the efficacy of surgery. Materials and Methods Forty-one patients who were expected to undertake mitral valvuloplasty （valvuloplasty group） underwent 2D and 3D images in one week before operation, one week after operation and six months alter operation. The maximum volume of the left atrium （LAVmax）, the minimum volume of the left atrium （LAVmin）, the left atrial volume pre-contraction （LAVpreA）, the left atrial global ejection fraction （LAEF）, the left atrial passive empty fraction （LAEFpassive）, and the initiative ejection fraction （LAEFactive） were measured. STI was used to measure strain ratio of left atrial anterior wall, posterior wall, side wall, inferior wall and atrial septal. The mean value was calculated. Twenty-five healthy volunteers were enrolled as controls. Results Preoperative mean systolic peak strain ratio （mSRs）, peak early diastolic strain ration （mSRt）, and peak late diastolic strain ratio （mSRA） decreased in valvuloplasty group when compared with those of the control group （P〈0.05）. Postoperative mSRs and mSR~ were significantly higher than those preoperative （P〈0.01） and mSR was slightly higher （P〉0.05）. Preoperative LAVmax, LAVmin and LAVpreA of valvuloplasty group were higher than those of the control group （P〈0.01）. Left atrial volume was significantly reduced after valvuloplasty （P〈0.05）. Both LAEF and LAEFpassive were significantly increased after valvuloplasty （P〈0.01）. mSRE of valvuloplasty group was positively correlated with LAEFpassive, mSRA was positively correlated with LAEFactive in one week before surgery, one week after surgery and six months after surgery, respectively （r=0.957, 0.787; r=0.993, 0.806; r=0.992, 0.723; P〈0.01）. Conclusion Both SRI and RT3DE have abi

关 键 词：心脏瓣膜疾病 二尖瓣 心脏外科手术 超声心动描记术 多普勒 彩色 超声心动描记术 三维 斑点追踪成像 心房功能 左 

分 类 号：R654.2[医药卫生—外科学] R445.1[医药卫生—临床医学]