二维超声斑点追踪技术评价不同节段急性心肌梗死患者左心室解旋运动  

Assessment of the left ventricular untwisting in patients with acute myocardial infarction in different location by two-dimensional speckle tracking imaging

作　　者：宋宏宁[1] 周青[1] 陈金玲[1] 黄佳[1] 胡波[1] 郭瑞强[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060

出　　处：《中华超声影像学杂志》2013年第4期277-281,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用二维斑点追踪（2D-STI）技术评价不同节段急性心肌梗死（AMI）患者左室解旋运动的变化规律，寻找定量评价左室解旋运动的敏感指标，探讨心肌梗死部位及节段数对左室解旋运动的影响。方法41例急性心肌梗死患者根据心肌梗死部位分为急性前-间壁心肌梗死组及急性下-后壁心肌梗死组，对照组31例。自动功能成像技术获取左室收缩峰值纵向应变（LPSS）及其牛眼图，评估心肌梗死的部位及节段数量。取左室心尖和心底短轴二维图像，计算收缩末期扭转角度（AVCtw）、等容舒张末期扭转角度（MVOtw）、等容舒张期解旋率（UntwR）、解旋速度峰值（PUV）、解旋角速度达峰时间（TPUV）和解旋减半时间（UHT）。结果与对照组相比，急性心肌梗死组的左室射血分数（LVEF）、左室整体LPSS、PUV、Untw-R明显减低（P〈0．001）；T—PUV（P〈0．001）、UHT（P=0．028）显著增高；心肌梗死节段数量与Untw-R呈显著负相关（r=-0．420，P=0．006），与UHT、PUV、TPuV无显著相关；前-间壁心肌梗死组Untw—R明显低于下-后壁心肌梗死组（P=0．022）；前-间壁心肌梗死组与下-后壁心肌梗死组之间的PTV、PTw、T-Ptw、PUV、UHT、T-PUV差异无统计学意义。结论2D-STI技术可以定量观测急性心肌梗死患者左室解旋运动。Untw-R可以作为评价急性心肌梗死患者左室解旋运动的敏感指标。急性心肌梗死患者左室解旋运动明显减低，前壁、前间壁心肌梗死患者左室解旋运动减低较下壁、后壁心肌梗死患者更为明显。Objective To assess left ventricular （LV） untwisting in patients with acute myocardial infarction（AMI） in different location by two-dimensional speckle tracking imaging（2D-STI）, searching for sensitive parameter to evaluate the untwisting motion, to explore the impact of myocardial infaretion（MI） location and number of MI segments on left ventricular untwisting movement. Methods Forty-one patient with AMI （AMI Group） were divided into two groups （anterior wall-anteroseptum group and inferior wall- posterior wall group） according to the MI location,and 31 age matched subjects were involved as the control group. Acquire the bull＇s eyes map of systolic strain （LPSS） values by automated function imaging（AFI） and locate the position and number of segments of MI by it. Access twist at aortic valve closure （AVCtw）, twist at mitral valve open （MVOtw）, peak twist velocity（PTV）, untwisting rate in IVRT （Untw-R）, peak untwisting velocity（PUV）,time to peak untwisting velocity（TPUV） and half time of untwisting （UHT） with STI. Results Compared with control group,left ventricular ejection fraction （LVEF）,global LPSS, PUV and Untw-R of AMI group decreased significantly （P d0. 001）, T-PUV （P d0. 001 ） and UHT （P = 0. 028） increased significantly. The number of MI segments correlated with Untw-R （r = -0. 420, P = 0. 006） significantly. There was no significant correlation between number of MI segments and UHT, PUV,TPUV. Untw-R in anterior wall-anteroseptum group were lower than inferior wall-posterior wall group（ P = 0. 022）. For PTV, PTW,T-Ptw, PUV,UHT and T-PUV, there was no significant difference between anterior wall-anteroseptum group and inferior wall-posterior wall group. Conclusions LV untwisting motion of AMI patients can be observed by 2D-STI. Untw-R is a sensitive parameter to evaluate the untwisting motion of AMI patients. The untwisting motion of AMI patients decrease significantly, even worse in anterior wall-anteroseptum AMI patien

关 键 词：超声心动描记术 心肌梗死 心室功能 左 斑点追踪显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]