二维斑点追踪显像技术评价早期心尖肥厚型心肌病的心肌应变  

Two-dimensional speckle tracking imaging in evaluation on myocardial strain of pre-apical hypertrophic cardiomyopathy

作　　者：宋光[1] 商聪[1] 张晶[1] 任卫东[1] 胡金玲[1] 乔伟[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：《中国介入影像与治疗学》2015年第9期549-553,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：辽宁省科技厅科学技术计划项目(2013225049)

摘　　要：目的探讨二维斑点追踪显像评价早期心尖肥厚型心肌病(PAHCM)患者心肌应变价值。方法对26例PAHCM患者(PAHCM组)、高血压左心室肥厚患者(高血压组)及健康志愿者(正常对照组),行二维超声心动图检查,记录二尖瓣、乳头肌和心尖水平左心室短轴及心尖四腔、三腔、二腔心切面的二维超声图像。使用QLab 9.1软件测量左心室壁各个节段圆周应变峰值(CS)、纵向应变峰值(LS),计算各水平(二尖瓣水平、乳头肌水平及心尖水平)的平均CS、LS及整体CS(GCS)、整体LS(GLS)。最后筛选出具有诊断效力的指标,并绘制ROC曲线评价诊断效果。结果与高血压组比较,PAHCM组二尖瓣水平、乳头肌水平CS、LS及左心室GCS、GLS的绝对值增加,而心尖水平CS、LS的绝对值减低,差异均有统计学意义(P均<0.05)。与正常对照组比较,PAHCM组乳头肌水平、心尖水平CS、LS及左心室GCS、GLS的绝对值减低,差异均有统计学意义(P均<0.05),而二尖瓣水平CS、LS的绝对值之间差异无统计学意义(P>0.05)。与正常对照组比较,高血压组各个水平CS、LS及GCS、GLS的绝对值减低,差异均有统计学意义(P均<0.05)。结论二维斑点追踪显像技术可以准确定量测量PAHCM患者心肌应变,反映心肌变形能力的变化。联合应用心尖水平CS和心尖水平LS可较好地识别和鉴别PAHCM。Objective To discuss two-dimensional speckle tracking imaging diagnostic value in evaluation of myocardial strain in the pre-apical hypertrophic cardiomyopathy （PAHCM） patients. Methods Respectively selected 26 cases of pa- tients with PAHCM （PAHCM group）, hypertensive left ventricular hypertrophy （HLVH group） and healthy volunteers （control group）. Two dimensional echocardiographs were performed carefully. Two-dimensional images were obtained from the left ventricular apical four-chamber section, three-chamber section, two-chamber section and three short-axis sec- tions, including mitral valve, papillary muscle and apical levels. The peak systolic circumferential strain （CS） and longitu- dinal strain （LS） of all segments were measured using QLAB 9.1 software. The effective diagnostic characteristics were analyzed and ROC curve was drawn to assess diagnostic efficacy. Results OCompared with the HLVH group, the abso- lute value of CS, LS at mitral valve level, papillary muscle level and left ventricular global CS （GCS）, global LS （GLS）in PAHCM group increased, while the absolute value of CS and LS at apical level decreased, the difference was statistically significant （P〈0.05）. （2）Compared with the control group, the absolute value of CS, LS at papillary muscle level, apical level and left ventricular GCS, GLS in PAHCM group decreased, the difference was statistically significant （P〈0.05）, and there was no significant difference of the absolute value of CS, LS at mitral level between two groups （P〈0.05）. （3） Compared with the control group, the absolute value of CS, LS at each level and left ventricular GCS, GLS in HLVH group decreased, the difference was statistically significant （P〈0.05）. Conclusion Two-dimensional speckle tracking im- aging could accurately and quantitatively measure the myocardial strain in PAHCM patients, which could reflect changes of myocardial deformation capacity. The combined use of CS and LS at apical level could accurately

关 键 词：超声心动描记术 斑点追踪成像 心肌应变 心肌病 肥厚性 

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