组织多普勒超声评价核素心血池显像检测左心室同步化的研究  

Evaluation of Equilibrium Radionuclide Angiography in Detecting Left Ventricular Synchronization Using Tissue Doppler Ultrasound

作　　者：陈雨[1] 马树人[1] 谢雄伟[1] 李冬野[2] 李承宗[2] 任少阳[2] 

机构地区：[1]淮安市第一人民医院心内科,江苏淮安223000 [2]徐州医学院附属医院心内科,江苏徐州221000

出　　处：《中国医学影像学杂志》2013年第9期679-682,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨组织多普勒超声心动图及门控心血池显像技术测定心室收缩不同步参数的价值。资料与方法筛选39例慢性心力衰竭患者,包括左心室射血分数(LVEF)≤35%者18例,LVEF>35%者21例,同时纳入19名正常人作为对照。采集普通超声心动图、组织多普勒图像及核素心血池显像图像。采用QLab 4.2.1软件计算12个左心室节段达到峰值收缩速度时间的标准差(Ts-12SD)和最大差值(Ts-12Dif)及其与R-R间期的标化值(Ts-12SD%,Ts-12Dif%)。使用GE XT-ERNA软件自动和手动相结合进行常规和相位分析数据,获得左心室位相角平均数,左心室相角程、左心室峰相位标准差、左心室心尖-心底平均相峰之差(LVMP A-B)、左心室间隔-侧壁平均相峰之差(LVMP S-L),并计算与R-R间期标准化的左心室相角程(LVPS%)、左心室峰相位标准差(LVPSD%)。结果与正常人相比,慢性心力衰竭患者的Ts-12SD%、Ts-12Dif%、LVPS%、LVPSD%、LVMPA-B、LVMP S-L均显著增加(P<0.05),且LVEF≤35%组增加更明显(P<0.001);慢性心力衰竭患者左心室不同步参数LVPS%、LVMP A-B、LVMP S-L与Ts-12Dif%均呈显著正相关(r=0.816、0.763、0.791,P<0.001),LVPSD%与Ts-12SD%呈显著正相关(r=0.797,P<0.001)。结论 LVEF≤35%的慢性心力衰竭患者左心室不同步性比LVEF>35%的患者严重。核素心血池显像参数与组织多普勒超声心动图参数相关性较好,均可以较好地评价左心室不同步性。Purpose To explore the value of ventricular asynchrony parameters measured with tissue Doppler ultrasound and equilibrium radionuclide angiography. Materials and Methods Thirty＊nine patients with chronic heart failure were screened, including 18 cases with left ventricular ejection fraction （LVEF） _〈 35%, 21 cases with LVEF〉35%, and 19 healthy subjects as controls. Images of routine echocardiography, tissue Doppler imaging and equilibrium radionuclide angiography were acquired. 12 LV segments standard deviation （Ts-12SD）, maximal difference （Ts-12Dif） and standardized values with R-R interval （Ts-12SD% and Ts-12Dif%） were calculated with QLab 4.2.1 software. Conventional and phase analysis of the data was executed by GE XT-ERNA software automatically combined with manually, left ventricular average phase angle, left ventricular phase angle range, standard deviation of left ventricular peak phase, the difference of mean phase of the apex and the base of the LV （LVMP A-B）, the difference of mean phase of the septum and the lateral wall of the LV （LVMP S-L） were obtained, then R-R interval standardized LV phase shift （LVPS%） and standardization of LV phase standard deviation （LVPSD%） were calculated. Results Ts-12SD%, Ts-12l）if%, LVPS%, LVPSD%, LVMP A-B, LVMP S-L of patients with chronic heart failure increased significantly （P〈0.05） compared with normal subjects, and more significant increasing can be observed in the LVEF _〈 35% group （P〈0.001）; in patients chronic heart failure, LV asynchrony parameters LVPS%, LVMP A-B and LVMP S-L showed a significant positive correlation with Ts-12Dif% （r-0.816, 0.763, 0.791, P〈0.001）, but only LVPSD% was positively correlated with Ts-12SD% （r=0.797, P〈0.001）. Conclusion LeIt ventricular asynchrony of patients with LVEF 〈 35% is more severe than patients with LVEF〉35%. Parameters of radionuclide blood pool imaging are well correlated with tissue Doppler echocardiographic paraineters, thus both of them can eval

关 键 词：心力衰竭 超声心动描记术 多普勒 门控血池显像 心室功能 左 

分 类 号：R541.61[医药卫生—心血管疾病] R445.1[医药卫生—内科学]