斑点追踪成像评估房间隔缺损患儿左心室扭转运动的初步研究  

Left Ventricular Twist in Patients with Atrial Septal Defect by Speckle Tracking Imaging

作　　者：王梦宣 陈国珍 张玉奇[1] 吴兰平[1] 赵春 WANG Mengxuan CHEN Guozhen ZHANG Yuqi WU Lanping ZHAO Chun(Department of Pediatric Cardiology, Shanghai Children＇s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心内科,上海200127

出　　处：《中国医学影像学杂志》2017年第7期516-519,524,共5页Chinese Journal of Medical Imaging

摘　　要：目的采用斑点追踪成像(STI)评估房间隔缺损(ASD)患儿左心室扭转运动特征,探讨ASD患儿右心室容量负荷与左心室扭转运动的关系,以期指导临床应用。资料与方法收集2015年10月-2016年1月于上海儿童医学中心行心脏超声检查确诊为ASD患儿58例(病例组),并根据右心室容量分为右心室容量明显增加组(ASD-A组,30例)及右心室容量增加不明显组(ASD-B组,28例)。同时收集年龄、性别匹配的30例正常儿童为对照组。应用STI测量并比较各组左心室扭转运动参数。结果 ASD-A组中6例患儿基底部与心尖部均呈逆时针旋转。与对照组相比,ASD-A组左心室基底部旋转角度、心尖部旋转角度均明显增大,差异有统计学意义(P<0.01);左心室扭转角度峰值及扭力大于对照组,差异有统计学意义(P<0.05)。与对照组相比,ASD-B组仅心尖部旋转角度显著性增大(P<0.05),其余左心室扭转运动参数呈增大趋势,但差异均无统计学意义(P>0.05)。结论 ASD导致右心容量负荷明显增加时对左室基底部旋转运动及心尖部旋转运动具有较大影响。Purpose To evaluate features of the left ventricular twist in patients with atrial septal defect（ASD） using speckle tracking imaging（STI） in order to guide clinical application. Materials and Methods Fifty-eight patients with ASD confirmed by ardiac ultrasound in Shanghai Children’s Medical Center from October 2015 to January 2016 were enrolled in this study as case group, which were further divided into group ASD-A with 30 cases and group ASD-B with 28 cases according to the volume of right ventricular. The volume of right ventricular was significantly increased in the group ASD-A, but the volume of right ventricular was not significantly increased in the group ASD-B. At the same time, 30 normal children with matched age and sex were chosen as control group. The parameters of left ventricular twist motion in each group were measured and compared by using STI. Results In group ASD-A, The basal and apical part of 6 children rotated counterclockwise. Compared with those in the control group, the basal rotation angle and apical rotation angle of left ventricular in group ASD-A were significantly higher（P〈0.01）, and the peak twist and torison of left ventricular in group ASD-A were also higher（P〈0.05）. Compared with those in the control group, only the apical rotation angle in group ASD-B was higher（P〈0.05）, but the rest parameters of the left ventricular twist motion in group ASD-B were not statistically significantly higher（P〉0.05）. Conclusion The significant increase in the volume of right heart load in ASD impacts on the basal and apical rotation of left ventricular.

关 键 词：房间隔缺损 超声心动描记术 斑点追踪成像 心脏容量 异常扭转 心室功能 左 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学] R540.4[医药卫生—诊断学]