斑点追踪显像对急性冠状动脉闭塞早期左室节段旋转的评价  

Assessment of left ventricular regional rotation in early phase of acute coronary occlusion by speckle tracking imaging

作　　者：范莉[1] 颜紫宁[1] 黄俊[1] 宋香廷[1] 芮逸飞[1] 沈丹[1] 陈冬亮[1] 

机构地区：[1]南京医科大学附属常州第二人民医院心超室,江苏常州213003

出　　处：《中国临床医学影像杂志》2013年第6期397-399,403,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:应用斑点追踪显像(STI)评价兔急性冠状动脉闭塞早期左室节段旋转角度,探讨该方法对左室节段功能评估的敏感性。方法:健康新西兰兔46只,开胸行左冠状动脉前支结扎术建立急性冠状动脉闭塞模型,在术前及术后10 min两次采集胸骨旁左室长轴、心尖四腔及两腔切面、左室短轴二尖瓣、乳头肌、心尖水平切面动态二维图像;测量常规参数:左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室短轴缩短率(LVFS)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF);应用STI技术分析左室三水平共18个节段的旋转角度。结果 :①LVEDD、LVESD、LVFS、LVEDV、LVESV、LVEF术后较术前差异均无统计学意义(P>0.05)。②左室二尖瓣水平术前下壁及后间隔旋转角度最大,前壁及侧壁旋转角度最小,术后各节段间旋转角度差异无统计学意义(P>0.05);心尖水平及乳头肌水平术前及术后各节段间旋转角度差异均无统计学意义(P>0.05)。③左室二尖瓣水平前间隔、后间隔、下壁及后壁的旋转角度术后较术前明显减小(P<0.05),前壁及侧壁旋转角度术后较术前无明显变化(P>0.05);心尖水平及乳头肌水平各节段旋转角度术后较术前均无明显变化(P>0.05)。结论:急性冠状动脉闭塞早期用STI评价左室节段旋转角度可以敏感的反映左室节段功能的改变。Objective： To assess the left ventrieular regional rotation of rabbit in early phase of acute coronary occlusion by speckle tracking imaging （STI）, in order to investigate the sensibility of this method to evaluate the regional function of left ventricle. Methods： Forty-six healthy New Zealand rabbits had opened had chest operation to establish acute coronary occlu- sion model by ligating the anterior branch of the left coronary artery. Dynamic two-dimensional image of parasternal left ven- ti＇icular long-axis, apical four-chamber and two-chamber view, mitral valve, papillary muscles and apex level in short-axis view were acquired twice pre-operation and 10 minutes post-operation. General parameters such as left ventricular end-dias- tolic diameter（LVEDD）, end-systolic diameter（LVESD）, fraction shortening（LVFS）, end-diastolic volume（LYEDV）, end-systolic volume（LVESV）, ejection fraetion（LVEF） were measured. Rotation angle of 18 regions in three level of left ventricle were anal- ysed by STI. Results： （~）There was no statistical difference between post-operation and pre-operation in LVEDD, LVESD, LVFS, LVEDV, LVESV, LVEF（P〉0.05）. （~）On mitral valve level rotation angle was the maximum in inferior and posterior-sep- tum, but the smallest in anterior and lateral pre-operation. There was no statistical difference of rotation angle among every region post-operation on mitral valve level, pre-operation and post-operation on papillary muscles and apex level （P〉0.05）. （~） Rotation angle of anterior-septum, posterior-septum, inferior and posterior on mitral valve level were obviously decreased post- operation（P〈0.05）, and there was no statistical difference of anterior and lateral on mitral valve level, every region on papillary muscles and apex level between post-operation and pre-operation （/：＇〉0.05）. Conclusion： Assessment of left ventricular regional rotation in early phase Of acute coronary occlusion by STI can sensitively reflect the change

关 键 词：动脉闭塞性疾病 冠状动脉疾病 心室功能 左 超声心动描记术 多普勒 彩色 

分 类 号：R543.3[医药卫生—心血管疾病] R540.45[医药卫生—内科学]