斑点追踪成像技术评价表阿霉素对乳腺癌患者左心室心肌纵向分层应变的影响  

Speckle tracking imaging in evaluation of effect of Eprirubicin on left ventricular myocardial strain in breast cancer patients

作　　者：崔洪岩[1] 礼广森[1] 张宇虹[1] 黄冬梅[1] 

机构地区：[1]大连医科大学附属第二医院超声科,辽宁大连116027

出　　处：《中国介入影像与治疗学》2016年第12期753-756,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：辽宁省教育厅科学研究计划资助(05L109)

摘　　要：目的 探讨二维斑点追踪成像（2D-STI）分层应变技术评价表阿霉素（Epi）对左心室各层心肌纵向收缩功能影响的价值。方法 140例乳腺癌术后患者,分为3组：A组,40例,平均年龄（52.1±6.1）岁,未给予化疗;B组,50例,平均年龄（50.9±7.3）岁,化疗方案为环磷酰胺＋Epi＋5-氟尿嘧啶,Epi累积剂量180~240 mg/m2;C组,50例,平均年龄（54.4±7.4）岁,与B组化疗方案相同,Epi累积剂量≥360mg/m2。分别获取患者左心室心尖位四腔、二腔切面、左心室长轴切面二维图像,并测定各层心肌的纵向应变峰值（LS）及常规超声参数。结果 3组患者心肌常规超声心动图参数差异无统计学意义（P〉0.05）;A、B、C组的LS至内向外逐层递减,即：心内膜下心肌〉中层心肌〉心外膜下心肌;3组间心外膜下心肌、中层心肌LS差异无统计学意义（P〉0.05）;A组与B组心内膜下心肌LS差异无统计学意义（P〉0.05）,C组与A组心内膜下心肌LS、C组与B组心内膜下心肌LS差异有统计学意义（P〈0.05）。结论 2D-STI心肌纵向分层应变可精确反映Epi对各层心肌的浸润程度,其影响主要在心内膜层。Objective To evaluate effect of Epirubicin （Epi） on the longitudinal systolic function of left ventricular subendocardial, midmyocardium and subepicardial myocardium using layer-specific strain by speckle tracking imaging （STI） in patients with breast cancer. Methods One hundred and forty breast cancer patients were divided into three groups. Group A as the control group had forty patients after surgery without chemotherapy; Group B had fifty patients that were given Epi of 180-240 mg/m2; Group C had fifty patients that were given Epi of ≥360 mg/m2. Two-dimensional images were recorded from the apical four-chamber view, two-chamber view and long-axis view of the left ventricle during three consecutive cardiac cycles on basal. Peak systolic longitudinal strain （LS） were measured in subendocardium, midmyocardium, subepicardium. Results The conventional echcardiographic parameters had no significantly difference among three groups （P〉0.05）. In three groups, the LS of subendocardium was the highest, and subepicardium was the lowest. LS of subepicardium and midmyocardium had no significant difference in three groups （P〉0.05）; LS of subendocardium had no significant difference in groups A and B （P〉0.05）, but had significant difference in group A and group C, group B and group C （P〈0.05）. Conclusion The change of left ventricular longitudinal systolic function dysfunction is mainly in the subendocardium by layer-specific strain.

关 键 词：斑点追踪成像 表阿霉素 分层应变 心室功能 左 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]