三维斑点追踪成像技术评价左心室心肌致密化不全患者左心室收缩功能  

Evaluation on left ventricular systolic function using three-dimensional speckle-tracking echocardiography in patients with left ventricular noncompaction

作　　者：吕慧娜[1] 任卫东[1] 孙璐[1] 毕文静[1] 乔伟[1] 肖杨杰[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2015年第4期255-259,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:应用超声三维斑点追踪成像技术(3D-STE)评价左心室心肌致密化不全(LVNC)患者左心室整体及局部心肌收缩功能。方法:对31例LVNC患者(LVNC组)及31名健康志愿者(对照组)行超声检查,采集三维全容积图像并分析,测量常规超声心动图指标与左心室整体及各节段面积应变(GAS/AS)、纵向应变(GLS/LS)、径向应变(GRS/RS)、圆周应变(GCS/CS),并进行组间及组内比较。采用Pearson相关分析检验GAS与各指标间相关性。结果:1与对照组相比较,LVNC组左心室舒张末期内径(LVEDD)、左心室舒张末期容积(EDV)、左心室收缩末期容积(ESV)、左心室球形指数(SPI)值均增加,舒张末期室间隔厚度(IVSd)、舒张末期左心室厚壁厚度(LVPWD)、射血分数(EF)值均减低(P均<0.01)。2与对照组相比较,LVNC组左心室GAS、GLS、GRS、GCS均减低(P均<0.01)。3LVNC组非致密节段心肌(心尖及乳头肌水平)较同一水平致密节段心肌AS、LS、RS、CS均减低(P均<0.05)。4LVNC患者GAS与EF呈正相关,与EDV、ESV、SPI呈负相关。结论:LVNC患者左心室整体及局部心肌收缩功能减低,且以非致密节段心肌收缩功能减低更为明显,应用超声3D-STE可对LVNC患者左心室局部心肌功能进行定量评价。Objective： To evaluate the left systolic function of noncompacted and compacted left ventricular segments in patients with left ventricular noncompaction（LVNC） using three-dimensional speckle-tracking echocardiography（3D-STE）. Methods： Thirty-one patients with LVNC（LVNC group） and thirty-one healthy volunteers（Control group） were enrolled in the study.Three-dimensional full-volume image storage was acquired. Parameters of two-dimensional echocardiography and left ventricular global area strain（GAS/AS）, longitudinal strain（GLS/LS）, radial strain（GRS/RS） and circumferential strain（GCS/CS） between groups and within groups were measured respectively. The correlations of GAS with the above parameters were analyzed. Results： 1Compared with control group, LVEDD, EDV, ESV and SPI of the patients with LVNC increased significantly（P0.01）, while IVSd, LVPWD and EF reduced significantly（P0.01）. 2Compared with control group, GAS, GLS, GRS and GCS reduced significantly（P0.01）. 3AS, LS, RS and CS at the level of the papillary muscle and the apical of noncompacted myocardium in patients with LVNC reduced compared with those of compacted segments at the same level（P0.05）. 4It showed a positive correlation between GAS and EF, and negative correlations between GAS and EDV as well as ESV and SPI. Conclusion： Left ventricular systolic function reduces in patients with LVNC with the most obvious reduction in the noncompacted segmental systolic function. 3D-STE can accurately assess left ventricular function in LVNC patients, which is a noninvasive and sensitive tool to detect regional systolic dysfunction of noncompacted myocardium.

关 键 词：心肌疾病 心室功能 左 超声心动描记术 三维 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]