应用二维斑点追踪技术评价左室心肌节段应变的可靠性  

Appraisal the reliability of left ventricular segmental myocardial strain by 2 dimensional speckle tracking imaging

作　　者：吴红宁[1] 曹怡[1] 王燕[1] 杨慧[1] 李滨滨[1] 

机构地区：[1]南京市胸科医院功能检查科,江苏南京210029

出　　处：《现代医学》2014年第2期117-121,共5页Modern Medical Journal

摘　　要：目的:探讨与组织多普勒成像(TDI)技术相比,应用二维斑点追踪成像(2D-STI)评价左室心肌纵向节段应变性(STR)的可靠性。方法:选择健康志愿者35例,应用2D-STI和TDI技术分别测量左心室前壁、侧壁、后壁、下壁、室间隔及前间隔的基底段、中段及心尖段共18个节段心肌的纵向STR,观察其规律性。然后从35例志愿者中随机抽取10例,应用上述两种技术由同一观察者分别测量两次、再由两名观察者测量1次左室各壁基底段STR,对其测值进行变异系数、相关系数、平均差值等比较。结果:(1)2D-STI检测显示,STR基底段<中段<心尖段;TDI检测显示STR基底段>中段及心尖段。两种方法测得的部分相同室壁不同节段的STR值差异有统计学意义(P<0.05或P<0.01),不同室壁相同节段的STR值差异无统计学意义(P>0.05)。(2)应用2D-STI测出的左室各壁基底段、中段、心尖段STR的变异系数均较TDI测出值低(分别为-0.25、-0.23、-0.26 vs-0.33、-0.35、-0.40)。(3)同一观察者可靠性:两次应用2D-STI法测得各室壁基底段的STR值差异无统计学意义(P=0.86),两次STR值的相关系数为0.73(P<0.001),两次STR值的平均差值为(-0.00±3.19)%。两次应用TDI法测得各室壁基底段的STR值差异有统计学意义(P=0.002),两次STR值的相关系数为-0.10(P>0.05),两次STR值的平均差值为(3.98±9.36)%。两种方法测得的STR平均差值比较,差异有统计学意义(P<0.001)。(4)观察者之间可靠性:应用2D-STI法两者测得各室壁基底段的STR值差异无统计学意义(P=0.98),两者STR值的相关系数为0.60(P<0.001),两者STR值的平均差值为(-0.02±3.87)%。应用TDI法两者STR测值差异有统计学意义(P=0.00),两者STR值的相关系数为-0.11(P>0.05),两者STR值的平均差值为(4.86±10.26)%。两种方法测得STR的平均差值差异有统计学意义(P<0.001)。结论:应用2D-STI法定量评价左室局部心肌长轴的收缩功能更可靠。Objective： To evaluate the reliability of left ventricular（LV） segmental myocardial longitudinal strain（STR） by 2 dimensional speckle tracking imaging （2D-STI） compared with tissue Doppler imaging （TDI）. Methods： 2D-STI and TDI were performed in 35 healthy volunteers. Myocardial longitudinal STR of basal, mid and apical segments of anterior, lateral, posterior, inferior, septum and anterosept walls of LV were obtained. Ten cases were chosen randomly out of the 35 volunteers. Basal 2D-STI-STR and TDI-STR of LV were obtained independently by two observers and measured twice by each observer to compared the coefficient of variation （ CV）, correlation coefficient（CC） and mean difference（MD）. Results： （1） 2D-STI showed the value of STR： basal 〈 mid 〈 apical,TDI- STI ： basal 〉 mid and apical. Part of strain values of the same wall different segments of LV had no significant difference （P 〈0.05, P 〈0.01 ） and different walls of the same segments of LV had no significant difference（P 〉0.05 ） in two methods. （2） 2D-STI showed CV was lower than that of TDI（ LV basal, mid and apical segments of walls were - 0.25, - 0.23, - 0.26 vs - 0. 33, - 0.35, - 0.40 respectively）. （ 3 ） Intra- observer reliability： The values of STR of basal segments of LV were measured twice by one expert. There were no significant difference in the values of STR of basal segments of LV（P =0.86）, CC was 0.73（P 〈0. 001 ） and MD was （0.00 ＋ 3.19）% by 2D-STI. There were significant difference in the values of STR of basal segments of LV （ P = 0. 002） , CC was - 0. 10 （ P 〉 0.05 ） and MD was （ 3.98 ±9.36 ） % by TDI- STI. There was significant difference in MD by two methods（ P 〈 0. 001 ）. （4） Inter-observer reliability： The values of STR of basal segments of LV were measured independently by two experts. There were no significant difference in the values of STR of basal segments of LV （ P = 0.98 ）, CC was 0.60 （ P 〈 0.001 ） and

关 键 词：二维斑点追踪成像 组织多普勒成像 应变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R331.31[医药卫生—诊断学]