左室心肌速度测量位点选择及在舒张功能障碍分级中的价值  

The Site Selection of Left Ventricular Myocardial Velocity and the Value in Left Ventricular Diastolic Dysfunction Classification

作　　者：张威威[1] 魏立亚[1] 刘俐[1] 杨晓东[1] 彭伟彬[1] 郑家跃 陈芸[1] 

机构地区：[1]安徽医科大学北京大学深圳医院临床学院北京大学深圳医院,广东省深圳市518036

出　　处：《中国超声医学杂志》2016年第11期983-985,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的运用速度向量成像技术(VVI)探究舒张早期左室纵向心肌峰值速度(Ev)测量位点选择及在舒张功能障碍分级中的临床价值。方法 223例患者经过常规超声检查,基于舒张功能评估指南分为舒张功能正常组(124例)和异常组(99例),异常组包括舒张功能障碍Ⅰ级57例、Ⅱ级37例、Ⅲ级5例,分析VVI相应指标:舒张早期左室纵向各节段心肌峰值速度平均值(GMEv)、二尖瓣环6个节段平均值(6MEv)、心尖四腔心切面二尖瓣环侧壁心肌Ev和室间隔心肌Ev以及两者的平均值(2MEv)。结果 (1)侧壁Ev、室间隔Ev、2MEv、6MEv及G-MEv在舒张功能正常组和异常组间差异具有统计学意义(P<0.05),而在异常组中舒张功能Ⅰ级、Ⅱ级、Ⅲ级障碍两两间比较差异不具有统计学意义(P>0.05)。(2)侧壁Ev、室间隔Ev、2MEv、6MEv及G-MEv的ROC曲线下面积分别是0.85、0.87、0.89、0.95、0.95(P均<0.01),截断值分别为4.6、5.8、4.9、4.9、4.0。(3)6MEv、G-MEv的曲线下面积分别与侧壁Ev、室间隔Ev、2MEv间均具有差异性(P<0.01),而2MEv的曲线下面积与侧壁Ev间具有差异性(P<0.01),与室间隔Ev间差异不具有统计学意义(P>0.05)。结论 Ev对诊断舒张功能异常具有一定临床价值,但尚不认为能够评估舒张功能障碍的严重程度。此外,2MEv是一个较好的测量位点,但对于多节段心肌功能异常,G-MEv可能是一个较好的测量位点。Objective To explore the site selection of early diastolic left ventricular longitudinal myocardial peak velocity （Ev） and the value in diastolic dysfunction classification by Velocity Vector Imaging （VVI）. Methods 223 subjects were examined by conventional eehocardiography. Based on the guidelines of diastolic function assessment, they were divided into normal group （124 cases） and abnormal group （99 cases）, and the abnormal group included diastolic dysfunction I grade 57 cases, II grade 37 cases, III grade 5 cases. Then, analysis VVI corresponding indicators, which included left ventricular longitudinal myocardial mean peak veloeity（G-MEv）, mitral annulus six segments myocardial mean peak velocity（6MEv）, apex four chamber mitral annulus lateral myocardial peak velocity（lateral Ev） and septal myocardial peak velocity（septal Ev） and the mean velocity of above two velocities（2MEv）. Results （1） Lateral Ev,septal Ev, 2MEv, 6MEv and G-MEv differed statistically significant between abnormal group and normal group （P〈0.05,respectively）, but which above were not statistically significant among diastolic function I grade, II grade, III grade. （2） The ROC curve area of lateral Ev, septal Ev, 2MEv, 6 MEv and G-MEv were respectively 0.85, 0. 87, 0. 89, 0.95, 0. 95 （P〈0.01）. the diagnostic threshold were respectively 4.6, 5. 8, 4. 9. 4.9, 4.0. （3） It was found that the ROC curve area was significantly different in 2 MEv and G-MEv compared with lateral Ev. septal Ev, 2MEv, respectively （P〈0.01）, and that 2MEv was compared with lateral Ev （P〈0.01）, while compared with septal Ev （P〉0.05）. Conclusions Ev has a certain clinical value in diagnosis of diastolic dysfunction, but it may not be consider that it can assess the severity of diastolic dysfunction. In addition, 2MEv in apex four chambers was a better site, but for multiple segmental left ventricular myocardial dysfunctions, G-MEv may be a better site.

关 键 词：速度向量成像技术 舒张功能障碍 位点 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]