超声斑点追踪成像技术评价多发性骨髓瘤患者左心室收缩期旋转运动  

Speckle tracking imaging in evaluation of left ventricular myocardial systolic rotationin patients with multiple myeloma

作　　者：余芬[1] 杨顺实[1] 孙晓枫 李晶晶[1] 张艺 

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院超声影像科,湖北武汉430000

出　　处：《中国医学影像技术》2018年第2期228-231,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用超声斑点追踪成像技术观察左心室射血分数(LVEF)正常的多发性骨髓瘤(MM)患者心肌收缩期旋转运动。方法将42例MM(LVEF≥50%)分为室壁厚度正常组(n=14)及室壁增厚组(n=28),以30名健康体检者为正常对照组,行常规超声参数测定及二维斑点追踪成像分析。结果在左心室短轴二尖瓣水平,室壁厚度正常组和室壁增厚组心内膜下心肌、心肌整体旋转角度均较正常对照组减低(P均<0.05)。在心尖水平,室壁增厚组心内膜下心肌、心肌整体旋转角度均较正常对照组减低(P均<0.05),室壁厚度正常组心内膜下心肌、心肌整体旋转角度与正常对照组间差异无统计学意义(P均>0.05)。病变组左心室扭转角度均较正常对照组减低(P均<0.05),3组间左心室心外膜下旋转角度在二尖瓣水平及心尖水平差异均无统计学意义(P均>0.05)。结论多发性骨髓瘤患者在常规心脏超声出现特征性改变之前,左心室心肌旋转功能已受损,且以心内膜下心肌为著。Objective To evaluate myocardial systolic rotation with speckle tracking imaging in multiple myeloma （MM） patients with normal left ventricular ejection fraction （LVEF）. Methods A total of 42 patients with MM （LVEF≥50%） and 30 healthy controls （control group） were included, and the general and 2D echocardiographic parameters were analyzed. MM patients were divided into normal ventricular wall group （n=14） and thickened ventricular wall group （n=28）. Results At mitral valve level, the suhendocardial myocardium rotation and the whole myocardium rotation in normal ventricular wall. group and thickened ventricular wall group reduced compared with those in control group （all P（0.05）. At apical level, the subendocardial myocardium rotation and the whole myocardium rotation in thickened ventricular wall group reduced compared with those in control group （both P〈0.05）, and the differences of the subendocardial myocardium rotation and the whole myocardium rotation were not statistically significant between normal ventricular wall group and control group （both P〉0. 05）. LV torsion in normal ventricular wall group and thickened ventricular wall group reduced compared with control group （ both P % 0.05 ）. The differences of subepicardial myocardium rota＊ion were not significant neither in mitral valvee level nor in apical level among three groups （P〉0. 05）. Conclusion LV rotation in patients with MM has been impaired before the appearance of characteristic echoeardiographic changes, especially in subendocardial myocardium.

关 键 词：多发性骨髓瘤 超声心动描记术 心室功能 左 

分 类 号：R733.3[医药卫生—肿瘤] R540.45[医药卫生—临床医学]