二维斑点追踪技术联合实时三维超声心动图评价下壁、后壁心肌梗死患者左心室收缩功能及同步性  

Evaluation of left ventricular systolic function and synchrony in patients with inferior and posterior myocardial infarction using two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography

作　　者：徐莉[1] 汪健飞[1] 郑枫[1] 张国辉[2] 

机构地区：[1]江苏大学附属人民医院心脏彩超室,江苏镇江212002 [2]江苏大学附属人民医院心内科,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2016年第5期410-414,共5页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:联合应用二维斑点追踪技术(two-dimensional speckle tracking imaging,2DSTI)与实时三维超声心动图(real-time three-dimensional echocardiography,RT-3DE)评价下壁、后壁心肌梗死患者左心室收缩功能与同步性。方法:对20例下壁、后壁心肌梗死患者(心肌梗死组)及健康对照组20例行常规超声心动图检查,获得左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF);同时存储心尖四腔心观、二腔心观、左室长轴观及二尖瓣水平、乳头肌水平、心尖水平左室短轴观的足够帧频二维图像。采用Qlab 9.0软件分析收缩期峰值纵向应变及圆周应变。采用RT-3DE获取左心室全容积图像,用Qlab 9.0软件获得左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、每搏输出量(SV)及射血分数(EF3d),并分析左心室16节段达收缩期最小容积点时间的标准差(Tmsv16-SD)及最大时间差(Tmsv16-Dif),并对标准差及时间差进行心率校正。结果:两种方法测得的LVEF值心肌梗死组明显小于健康对照组(P<0.05),LVEDD、LVESD、LVESV明显大于健康对照组(P<0.05),SV明显小于健康对照组(P<0.05);心肌梗死组下壁、后壁对应节段及相邻的部分节段纵向应变及圆周应变均比健康对照组明显降低(P<0.05);心肌梗死患者Tmsv16-SD校正值和Tmsv16-Dif校正值均明显大于健康对照组(P<0.01)。结论:2DSTI和RT-3DE能更加准确无创地判断下壁、后壁心肌梗死患者的节段性室壁运动异常及不同步性。Objective：Two-dimensional speckle tracking imaging（2DSTI）and real-time three-dimen-sional echocardiography（RT-3DE）were used to evaluate the left ventricular systolic function and synchrony in patients with inferior and posterior myocardial infarction.Methods：A total of 20 patients with inferior and posterior myocardial infarction （MI）and 20 healthy controls were enrolled in this study.Echocardio-graphy was performed to collect the left ventricular end-diastolic internal diameter （LVEDD）,left ventricu-lar end-systolic internal diameter （LVESD）,ejection fraction （EF）.We also collected the imagine clips of two cavity,four cavity,long axis at apex.In addition,we collected the imagine clips of short axis at mitral valve,papillary muscle and apex levels.Peak systolic longitudinal strain （L.Strain）and peak systolic cir-cumferential strain （C.Strain）were analyzed by Qlab 9.0 software.We used RT-3DE to obtain the left ventricular full-volume images and used Qlab 9 .0 software to analyze data,such as the end diastolic volume （LVEDV）,end systolic volume （LVESV）,stroke volume （SV）and ejection fraction （EF）of left ventric-ular,we also calculated the time to minimal systolic volume （Tmsv）of 1 6 segments and the maximal differ-ence of corresponding segments （Tmsv1 6 Dif）.The above parameters as a percentage of the cardiac cycle＆nbsp;with different heart rates between patients were also calculated from the Qlab 9.0 software,which were Tmsv1 6-SD /R-R（%）,Tmsv1 6-Dif /R-R（%）.Results：The LVEF detected by two ways in the MI group was significantly lower （P〈0.05）.The LVEDD,LVESD and LVESV were significantly higher and SV was significantly lower than those of the control （P〈0.05 ）.Both L.Strain and C.Strain of the inferior and posterior segments and part of adjacent segments in MI group were significantly lower than those in the con-trol （P〈0.05 ）.The Tmsv1 6-SD/R-R （%）and Tmsv1 6-Dif/R-R （%）in MI group were significantly higher than the

关 键 词：二维斑点追踪技术 实时三维超声心动图 心肌梗死 左心室功能 收缩同步性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.22[医药卫生—诊断学]