三维斑点追踪技术评价冠心病患者左室扭转运动及位移的初步研究  

Preliminary study of evaluating left ventricular twist and displacement in patients with coronary artery disease using three-dimensional speckle tracking imaging

作　　者：任兴香 王建华[1] 

机构地区：[1]北京军区总医院超声科,北京市100700

出　　处：《临床超声医学杂志》2014年第12期812-816,共5页Journal of Clinical Ultrasound in Medicine

基　　金：首都临床特色应用研究基金(Z121107001012143)

摘　　要：目的应用超声三维斑点追踪技术(3DT)评价冠状动脉粥样硬化(冠心病)患者左室扭转运动特征及位移参数,并探讨扭转与位移的相关性。方法冠状动脉造影确诊的冠心病患者120例,根据冠状动脉狭窄部位分为左前降支组(LAD组,n=47)、左旋支组(LCX组,n=25)、右冠状动脉组(RCA组,n=23)及多支病变组(n=25),左主干病变归入多支组。正常对照组40例。经胸采集左室三维全容积动态图像,存储后运用3DT软件进行脱机分析,得到左室整体、基底段、中间段及心尖段扭转角度峰值(PGT、PBT、PMT、PAT),左室三维位移(P3DD)、左室射血分数(LVEF)等指标。比较冠心病各组和对照组上述指标之间的差异,并分析左室扭转角度峰值与位移参数、LVEF的相关性。结果 1与对照组比较,冠心病组PGT、PAT、P3DD及LVEF均较低,差异均有统计学意义(均P﹤0.05);2LCX组、RCA组的PBT、PMT较对照组减低,差异无统计学意义(P﹥0.05);3LAD组PBT较对照组减低,差异有统计学意义(P﹤0.05);PMT较对照组减低,但差异无统计学意义(P﹥0.05);4多支组PMT、PBT较对照组减低,差异有统计学意义(P﹤0.05);5LAD组、LCX组、RCA组对应的左室节段、多支组左室各壁P3DD较对照组明显减低,差异有统计学意义(均P﹤0.05或0.01);6冠心病组扭转角度峰值与P3DD、LVEF均有一定相关性,PAT与LVEF、P3DD相关性最佳(r1=0.53,P1﹤0.05;r2=0.44,P2﹤0.05)。结论 3DT可以在三维立体空间内研究左室位移及扭转运动特征,从机械力学角度评价冠心病患者左室收缩功能减低。Objective To evaluate left ventricular（LV）twist and displacement in patients with coronary artery disease（CAD）using three-dimensional speckle tracking imaging（3DT）,and to explore the correlation between the two parameters.Methods One hundred and twenty patients with CAD diagnosed by coronary artery angiography were selected as CAD group,they were divided into 4 groups according to the distribution of affected coronary arteries：a left anterior descending coronary artery group（LAD group,n=47）,a left circumflex coronary artery group（LCX group,n=25）,a right coronary artery group（RCA group,n=23）,a multivessel group（n=25）.Forty healthy volunteers were included as control group.Real-time three-dimensional full volume dynamic images of left ventricular were acquired using transthoracic echocardiography and analysed off-line with 3DT analysis software.All parameters were collected,including the peak of left ventricular global twist（PGT）,basal segment twist（PBT）,middle segment twist（PMT）,apical segment twist（PAT）,the global 3D displacement（P3DD） and left ventricular ejection fraction（LVEF）.The above parameters of CAD group were compared with those of control group.The correlation between LV twist and displacement,LVEF was analyzed.Results 1 Compared with control group,PGT、PAT、P3DD and LVEF in CAD group decreased significantly（P ﹤ 0.05）;2 PBT and PMT in LCX group and RCA group decreased（P ﹥ 0.05）;3 PBT decreased（P﹤0.05）and PMT decreased（P﹥0.05）in LAD group;4PMT and PBT decreased in multivessel group（P﹤0.05）;5 P3 DD of corresponding segments in LAD group,LCX group,RCA group and all segments in multivessel group decreased significantly（P﹤0.05 or 0.01）;6index of LV twist had a significant correlation with P3 DD and LVEF in CAD group,especially for PAT（r1=0.53,P1﹤0.05;r2=0.44,P2﹤0.05）.Conclusion Left ventricular twist and displacement can be studied in three-dimensional space using 3DT.The new technology can evaluate left ventr

关 键 词：三维斑点追踪技术 扭转 位移 冠状动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]