三维及二维斑点追踪技术检测冠状动脉狭窄临床价值的对比研究  

Comparison efficiency of three-dimensional speckle tracking and two-dimensional speckle tracking imaging in detecting significant coronary artery stenosis

作　　者：汪彩英[1] 周青[1] 张才智 陈金玲[1] 胡波[1] 宋宏宁[1] 郭瑞强[1] 

机构地区：[1]武汉大学人民医院超声影像科,430060 [2]武汉市江夏区第一人民医院超声科

出　　处：《中华超声影像学杂志》2013年第8期654-658,共5页Chinese Journal of Ultrasonography

摘　　要：目的应用三维斑点追踪技术（3I〉STI）和二维斑点追踪技术（2D-STI）分析冠状动脉狭窄患者左心室局部和整体应变值，评价左心室收缩功能，比较两种技术检测冠状动脉狭窄的临床应用价值。方法对照组32例，冠状动脉狭窄组39例（均经冠状动脉造影确诊），冠状动脉狭窄组心肌节段分为缺血节段和非缺血节段，经胸采集左室二维及全容积三维动态图像，进行脱机分析，3D-STI指标包括：三维长轴应变（3I〉LS）、三维圆周应变（3EvCS）、三维径向应变（3DRS）、三维面积应变（3I〉AS）、三维整体长轴应变（3EVGLS）、三维整体圆周应变（3I〉GCS）、三维整体径向应变（3DGRS）、三维整体面积应变（3I〉GAS）；2D-STI指标包括：二维长轴应变（2I〉LS）、二维圆周应变（2I〉CS）、二维径向应变（21〉RS）、二维整体长轴应变（2DGLS）、二维整体圆周应变（2I〉GCS）、二维整体径向应变（2EVGRS）。比较二维和三维在冠状动脉狭窄组缺血节段和非缺血节段中的节段性应变均值及在对照组和冠状动脉狭窄组中的整体应变均值。并对2I〉STI和3D-STI的整体应变值和左室射血分数（LVEF）进行相关性分析。结果冠状动脉狭窄组缺血节段和非缺血节段的2D-LS、21〉CS、3D-LS、3D-CS、31〉AS差异有统计学意义（P〈0．05）。其中缺血节段的2D-LS、3I〉LS、3ERAS较非缺血节段明显减低（P〈0．001），ROC曲线表明2I〉LS、3I〉LS、3I〉AS诊断冠状动脉狭窄患者心肌缺血的灵敏度分别为60．1％、64．2％、74．0％，特异度分别为60．0％、61．0％、63．1％。对照组和冠状动脉狭窄组的2D-GCS、2I〉GRS差异无统计学意义（P〉0．05），而冠状动脉狭窄组的2I〉GLS、3nGLS、3DGCS、31〉GRS、3I）-GAS较对照组明显减低，差异有统计学意义（P〈0．05）。ROC曲线表明2I〉GI。S、3I〉GLS、3DGAS诊断冠状动脉狭窄�Objective To analyzed the left ventricular （LV） regional and global strains in coronary artery stenosis by using three-dimensional speckle tracking imaging （3D-STI） and two dimensional speckle tracking imaging （21〉STI） for the assessment of left ventricular systolic function, and to compare the clinical values between 3D-STI and 2D-STI in the detection of coronary stenosis. Methods 39 patients with coronary artery stenosis and 32 sex-age matched controls were enrolled in this study. Coronary artery stenosis group was divided into ischemic group and non-ischemic group. Real-time three dimensional full volume and two-dimensional dynamic image of the LV were obtained and then analyzed by off-line analysis software. The parameters of 3D-STI were three-dimensional longitudinal strain （3D-LS）, circumferential strain （3D-CS）,radial strain （3D-RS）, area strain （3D-AS）, global longitudinal strain （3D-GLS）, global circumferential train （3D-GCS） ,.global radial strain （3D-GRS） and global area strain （3D-GAS）. The parameters of 2D-STI were two-dimensional longitudinal strain （2D-LS）,circumferential strain （2D-CS）, radial strain （2D-RS）, global longitudinal strain （2D-GLS）, global circumferential train （2D-GCS） and global radial strain （2D-GRS）. The global/regional strains derived from 3D-STI and 2D-STI in patient group and controls were analyzed for comparing their efficacy in detecting coronary artery stenosis. Results Compared with non-ischemic group,2D-LS,2D-CS,3D-LS,3D-CS and 3D-AS were lower in ischemic group （ P d0.05）. ROC curves showed the sensitivity of 2D-LS,3D-LS and 3D-AS for the diagnosis of myocardial ischemia was 60.1 %, 64.2% and 74.0%, while the specificity of them was 60.0%,61.0% and 63.1%, respectively. There was no significant difference in 2D-GCS and 2D-GRS between coronary artery stenosis group and control group （ P 〈0.05）. Compared with control group, 2D-GLS, 3D-GLS, 3D-GCS, 3D-GRS and 3D-GAS were significantly lower in cor

关 键 词：超声心动描记术 冠状动脉狭窄 心肌缺血 斑点追踪显像 三维 

分 类 号：R543[医药卫生—心血管疾病]