脉冲多普勒组织成像技术对尿毒症患者左心室舒张功能的评价  

Assessment of left ventricular diastolic function in uremia patients by PW-DTI

作　　者：谌瑾寰 王跃群[2] 叶湘漓[3] 

机构地区：[1]湖南省长沙市第四医院(湖南师范大学医学院附属医院)超声诊断科,湖南长沙410006 [2]湖南师范大学生命科学院心脏发育研究中心,湖南长沙410081 [3]湖南师范大学医学院医学检验,湖南长沙410013

出　　处：《中国现代医学杂志》2014年第23期98-100,共3页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:30800627);湖南省自然科学基金(No:12JJ3117)

摘　　要：目的探讨脉冲多普勒组织成像(PW-DTI)技术在评价尿毒症患者左心室舒张功能中的价值。方法对102例尿毒症患者分别采用脉冲波多普勒法(PW)测量二尖瓣口前向血流速度参数:舒张早期峰值速度(E)、舒张晚期峰值速度(A),计算E/A比值;采用PW-DTI技术测量左室侧壁、前壁、下壁、室间隔的二尖瓣环水平DTI参数:舒张早期峰值速度(Em)、舒张晚期峰值速度(Am),计算Em/Am比值;对比分析两种检测方法。结果 102例尿毒症患者用PW法测得二尖瓣血流频谱E/A比值异常,例数为67例,异常例数检出率65%;启动PW-DTI测量程序后,二尖瓣环运动频谱Em/Am比值异常例数增至92例,异常例数检出率90%。PWDTI对尿毒症患者左心室舒张功能异常检出率明显高于PW法,其差异有统计学意义(χ2=21.59,P<0.01)。结论PW-DTI技术可以实时定量地反映心肌运动的方向与速度,客观评价左心室舒张功能,有效避免频谱多普勒检查中存在的假性正常化现象。[Objective] To discuss the value of Pulsed wave Doppler tissue imaging （PW-DTI） in assessment of left ventricular diastolic function in uremia patients. [Methods] 102 patients with uremia were selected for study. Pulsed wave Doppler （PW） was used to measure the indexes of mitral valve flow pattern as early diastolic flow velocity （E） and late diastolic peak velocity （A）, and the E/A ratio was calculated. Then PW- DTI was used to measure early diastolic motion velocity （Era） and late diastolic motion velocity （Am） of the four sites of the mitral annular. The four sites included the lateral wall, the anterior wall, the inferior wall and ventricular septum. Furthermore, the Era/Am ratio was calculated, and the two measurements were com- pared and analyzed. [Resultsl Using PW, 67 abnormal cases of E/A value （65%） were detected. While using PW-DTI, 92 abnormal cases of Em/Am value （90%） were detected, which is obviously higher than that of PW. The difference of abnormal cases between these two measure ways had statistically significant （x2 =21.59, P〈0.01）. [Conclusion] PW-DTI could be used to evaluate the direction and velocity of myocardium movement quantitatively and accurately, and provide assessment of left ventricular diastolic function which couht avoid pseudo normal in PW.

关 键 词：脉冲多普勒组织成像(PW-DTI) 尿毒症 左心室舒张功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]