三维斑点追踪成像结合二维超声评价不同程度肺动脉高压患者左心功能  

Evaluation of Left Ventricular Function in Patients with Different-stage Pulmonary Hypertension Using Three-dimensional Speckle Tracking Imaging Combined with Two-dimensional Ultrasound

作　　者：谭羽莹[1] 王小丛[1] 徐晶[1] 徐卉[1] 

机构地区：[1]吉林大学第一医院心脏超声科,吉林长春130012

出　　处：《中国医学影像学杂志》2017年第9期678-681,共4页Chinese Journal of Medical Imaging

基　　金：吉林省科技发展计划项目(2015Y034-4)

摘　　要：目的应用三维斑点追踪成像(3D-STI)结合二维超声定量评价肺动脉高压(PH)患者左心室收缩及舒张功能,探讨不同程度PH对左心室功能的影响。资料与方法回顾性分析2011年9月-2015年11月在吉林大学第一医院52例诊断为PH患者的临床资料,并根据肺动脉收缩压(PASP)分为轻度组(PASP 36~49 mmHg,n=20)、中度组(PASP 50~70 mmHg,n=18)、重度组(PASP>70 mmHg,n=14);同时选取健康志愿者作为对照组(n=30)。所有研究对象均留取二维及三维图像,利用二维超声获取左心室内径(LVDd)、左心室射血分数(LVEF)、左心房最大容积指数(LAVI)、PASP、e'及E/e'等指标;利用3D-STI获取左心室整体纵向应变(GLS)、左心室整体径向应变(GRS)、左心室整体圆周应变(GCS)及左心室整体面积应变(GAS)等指标。对比不同组间参数,分析PASP与左心收缩及舒张功能指标的相关性。结果 E/e'及LAVI在中度组、重度组较对照组均明显升高,差异有统计学意义(P<0.05);GLS及GAS在中度组绝对值较对照组减低,差异有统计学意义(P<0.05);重度组GLS、GRS、GCS及GAS绝对值均较对照组减低,差异有统计学意义(P<0.05)。相关性分析显示,二维参数中LAVI和PASP相关性较好(r=0.56,P<0.01);三维应变数值中GLS绝对值与PASP相关性较好(r=0.60,P<0.01)。结论 3D-STI结合二维超声能够有效评估PH患者左心收缩及舒张功能受损情况,为临床早期干预治疗提供理论支持。Purpose To evaluate the left ventricular systolic and diastolic function in patients with pulmonary hypertension（PH） using three-dimensional speckle tracking imaging（3D-STI） combined with two-dimensional ultrasound（2D ultrasound）, and to investigate the effects of different-degree PH on left ventricular function. Materials and Methods Fifty-two patients who were diagnosed as PH in the First Hospital of Jilin University from September 2011 to November 2015 were retrospectively analyzed, and based on pulmonary artery systolic pressure（PASP）, they were assigned into mild group（PASP 36-49 mmHg, n=20）, moderate group（PASP 50-70 mmHg, n=18） and severe group（PASP70 mmHg, n=14）. Besides, healthy volunteers were selected as control group（n=30）. All the subjects accepted 2D and 3D imaging, their left ventricular diastolic diameter（LVDd）, left ventricular ejection fraction（LVEF）, left atrial maximum volume index（LAVI）, PASP, e＇, E/e＇, etc., were obtained by 2D ultrasound, and their left ventricular global longitudinal strain（GLS）, left ventricular global radial strain（GRS）, left ventricular global circumferential strain（GCS）, left ventricular global area strain（GAS）, etc., were obtained by 3D-STI. The data of different groups were compared, and the correlation between PASP with left ventricular systolic and diastolic function was analyzed. Results E/e＇ and LAVI in moderate group and severe group were significantly higher than those in control group, and the differences were statistically significant（P〈0.05）; the absolute values of GLS and GAS in moderate group were lower than those in control group（P〈0.05）; the absolute values of GLS, GRS, GCS and GAS in severe group were all lower than those in control group, and the differences were statistically significant（P〈0.05）. The correlation analysis showed that among 2D parameters, the correlation between LAVI and PASP was better（r=0.56, P〈0.01）; among 3D strain values, the correlation betwe

关 键 词：高血压 肺性 心室功能 左 超声心动描记术 多普勒 彩色 超声心动描记术 三维 斑点追踪成像 

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]