实时三维超声及二维斑点追踪技术对拟诊冠心病患者局部室壁运动的评价  

Evaluation of Regional Wall Motion in Patients with Suspected Coronary Artery Disease by RealTime Three-Dimensional Echocardiography and Two-Dimensional Speckle Tracking Imaging

作　　者：田园[1] 王伟[1] 周长钰[1] 

机构地区：[1]天津医科大学第二医院心脏科,300211

出　　处：《天津医药》2014年第12期1229-1233,共5页Tianjin Medical Journal

摘　　要：目的探讨实时三维超声(RT-3DE)及二维斑点追踪成像(2D-STI)技术检测拟诊冠心病患者局部室壁运动功能的临床应用价值。方法选取临床拟诊为冠心病、二维超声示室壁运动正常的住院患者143例,根据冠脉造影左冠状动脉主干(LM)和(或)左前降支(LAD)和(或)左回旋支(LCX)病变结果分为狭窄≥75%组(A组)73例和狭窄<75%组(B组)70例。应用RT-3DE及2D-STI分别检测并比较2组患者左室节段射血分数(s EF)和收缩期纵向峰值应变(SL),利用ROC曲线比较2种技术诊断冠心病的曲线下面积。结果 (1)A组病变冠脉所支配室壁的s EF及SL均较B组减小(P<0.05);(2)节段平均s EF与节段平均SL呈正相关(r=0.689,P<0.05);(3)两项指标均显示异常的左冠供血各节段s EF对诊断供血冠脉狭窄≥75%的曲线下面积大于SL(最大曲线下面积分别为0.922和0.874)。结论 RT-3DE及2D-STI均可评估冠心病患者的心肌局部运动状况,进而推测冠脉病变程度,但RT-3DE指标可能更优于2D-STI。Objective To evaluate the clinical value of the regional wall motion in patients with suspected coronaryartery disease by real-time three-dimensional echocardiography（RT-3DE） and two-dimensional speckle tracking imaging（2D-STI）. Methods A total of 143 hospitaized patients with suspected coronary artery disease and normal wall motion de-tected by two-dimensional echocardiography（2DE） were enrolled and devided into group A（coronary stenosis ≥75%） 73 cases and group B（coronary stenosis 75%） that include 70 cases according to coronary angiography results. Left ventricu-lar segmental ejection fraction（s EF） was measured by RT-3DE and peak systolic longitudial strain（SL） was measured by 2D-STI. ROC curves of the two measurements were generated and compared. Differences in s EF and SLbetween group A andgroup B were respectively analyzed. Results（1）Both s EF of RT-3DE and SLof 2D-STI in group A were significantly low-er than those in group B（P〈0.05）;（2）s EF was positively correlated with SL（r=0.689,P〈0.05）;（3）Compared with SL, s EFhad larger area under ROC curve in some segments of left ventricle where both parameters are abnormal for the diagnosis ofthe coronary stenosis ≥75%（0.922 vs 0.874）. Conclusion Regional wall motion of left ventricular can be measured byboth RT-3DE and 2D-STI which can be both used to estimate the extend of stenosis of coronary artery. And RT-3DE is su-perior over 2D-STI.

关 键 词：冠心病 实时三维超声 二维斑点追踪技术 局部室壁运动 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]