三维斑点追踪成像技术对冠心病患者狭窄冠脉灌注区域局部应变的评价  

Three-dimensional speckle tracking imaging in evaluating local strain of stenosis coronary perfusion area in patients with coronary heart disease

作　　者：孙妍[1] 安莹波[2] 乔英艳[1] 吴山 孙琪玮[1] 江波[1] 王琴[1] 杨娅 

机构地区：[1]首都医科大学附属安贞医院超声诊断科,北京市100028 [2]北京市海淀医院急诊科 [3]安贞医院超声诊断科

出　　处：《中国心血管病研究》2015年第1期51-55,94,共6页Chinese Journal of Cardiovascular Research

摘　　要：目的 结合冠状动脉所属区域各项应变参数,分析冠状动脉狭窄对该局部区域应变的影响.方法 入选2012年5～11月我院行冠脉造影检查的拟诊或确诊冠心病51例,其中男性36例,女性15例,年龄40～70（56.01 ±8.55）岁.将所有人选者按三支冠脉分布区分为左前降支灌注区、左回旋支灌注区及右冠状动脉灌注区,共153个区域;按冠脉造影狭窄是否＞50％将各区域分组,共分为6组：左前降支狭窄≥50％组（25个）、左前降支狭窄＜50％组（26个）、回旋支狭窄≥50％组（23个）、回旋支狭窄＜50％组（28个）、右冠狭窄≥50％组（29个）和右冠狭窄＜50％组（22个）.所有入选者采集标准心尖四腔切面左心室全容积图像并存储,应用3DST在线分析软件获得各应变参数.将各冠脉灌注区域内各项应变等参数分别求和计算均数.分析冠心病左室局部应变等参数.结果 ①左前降支狭窄＜50％组与狭窄≥50％组的左前降支灌注区域各项应变平均值分别为：纵向峰值应变-16.17±5.26比-13.03±4.84,P＜0.01;周向峰值应变-31.79±14.10比-24.74±9.12,P＜0.01;径向峰值应变32.02±14.64比27.70±10.48,P＜0.05;心内膜面积应变-41.42±14.87比-33.54±11.74,P＜0.01.②回旋支狭窄＜50％组与狭窄≥50％组的回旋支灌注区域各项应变均值分别为：纵向峰值应变-14.95±6.01比-12.04±4.25,P＜0.05;周向峰值应变-28.46±15.09比-24.23±10.22,P＜0.05;径向峰值应变31.81±14.45比26.59±12.45,P＜0.05;心内膜面积应变-37.15±13.83比-30.47±12.29,P＜0.05.③右冠状动脉狭窄＜50％组与狭窄≥50％组的右冠状动脉灌注区域各项应变均值分别为：纵向峰值应变-14.23±5.01比-12.09±4.67,P＞0.05;周向峰值应变-28.47±11.95比-23.50±10.22,P＜0.05;径向峰值应变30.22±15.86比26.32±7.93,P＞0.05;心内膜面积应变-39.40±14.23比-30.29±10.84,P＜0.05.④冠脉分布区局部心内膜面积峰值应变对该区域灌注血�Objective To study the influence of coronary artery stenosis on the local area strain by coronary respective districts contingency parameter. Methods 51 patients （36 males and 15 females） undergone coronary angiography were enrolled in the study. Aged 40 to 70 years, average of （56.01±8.55）years old. Exclusion criteria： myocardial infarction, cardiomyopathy, congenital heart disease, severe valve disease, hypertension with ventricular hypertrophy, diabetes. Every left ventricular was divided into three perfusion areas including anterior descending （LAD） artery perfusion area, circumflex artery （LCX） perfusion area and right coronary artery（ RCA ） perfusion area. Those areas were divided into six groups according to whether coronary stenosis was less than 50%： anterior descending artery control group（n=26）, left anterior descending artery stenosis group（n=25 ）, circumflex artery control group （n=28）, circumflex artery stenosis group （n=23）, right coronary control group （n=22） and right coronary stenosis group （n=29）. Standard apical four-chamber view of left ventricular volume images were collected and stored for all selected patients. And 3DST online analysis software was used to obtain each strain parameters. The means of those parameters about the perfusion areas were calculated. The local strain parameters in patients with coronary heart disease were analyzed. Results （1）LS of the control and stenosis group of LAD perfusion area were （-16.17±5.26） and （-13.03±4.84）（P〈0.01）, CS were （-31.79±14.10） and （24.74±9.12）（P〈 0.01 ）, RS were （32.02±14.64） and （27.70±10.48）（P〈0.05）, AT were （-41.42±14.87） and （33.54±11.74）（P〈 0.01 ）. （2）LS of the control and stenosis group of LCX perfusion area were （-14.95±6.01） and （12.04±4.25）（P〈 0.05）, CS were （-28.46±15.09） and （-24.23±10.22）（P〈0.05）, RS were （31.81±14.45） and （26.59±12.45） （P〈0.05）, AT were （-37.1

关 键 词：三维 应变 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]