组织运动二尖瓣环位移自动追踪评价冠心病患者左心室整体收缩功能  

Evaluation of Left Ventricular Global Systolic Function in Patients with Coronary Heart Disease Using Tissue Motion Tracking of Mitral Annular Displacement

作　　者：段凤霞[1] 杜丽娟[1] 何文[1] 于腾飞[1] 张红霞[1] DUAN Fengxia;DU Lijuan;HE Wen;YU Tengfei;ZHANG Hongxia(Department of Ultrasound,Beijing Tiantan Hospital,Beijing 100050,China)

机构地区：[1]北京天坛医院超声科,北京100050

出　　处：《中国医学影像学杂志》2018年第3期175-179,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨应用组织运动二尖瓣环位移自动追踪(TMAD)技术评价冠心病患者左心室整体收缩功能的临床应用价值。资料与方法选择经冠状动脉造影证实的至少有1支冠状动脉狭窄程度≥70%的冠心病患者60例,35例健康志愿者作为对照组。采集心尖四腔、三腔、二腔连续3～5个心动周期二维动态图像,用Qlab 7.0软件进行脱机分析。测量二尖瓣环6个位点收缩期最大位移(Ds)、瓣环连线中点最大位移(D-mid)、左心室长轴缩短率(FSL),分别计算其均值,并与二维双平面Simpson法测量的左心室射血分数(LVEF)进行相关分析。结果①与对照组相比,冠心病组Ds、D-mid、FSL均显著降低,差异有统计学意义(P<0.05);②TMAD技术较二维双平面Simpson法测量时间明显缩短,差异有统计学意义(P<0.001);③对照组、冠心病组Ds、D-mid及FSL与LVEF呈正相关(r=0.77、0.75、0.78,P<0.001;r=0.78、0.79、0.78,P<0.001);④重复性检验:Ds、D-mid及FSL的观察者内的组内相关系数分别为0.87、0.85、0.93,观察者间的组内相关系数分别为0.84、0.84、0.88。结论 TMAD技术省时、准确、重复性好,可以评价冠心病患者的左心室收缩功能。Purpose To discuss the clinical value of applying tissue motion tracking of mitral annular displacement（TMAD） technique to evaluate left ventricular global systolic function in patients with coronary heart disease. Materials and Methods Sixty patients with coronary heart disease who had at least one coronary stenosis ≥70% confirmed by coronary angiography were selected, and 35 healthy volunteer were enrolled as the control group. Three to five sequential two-dimensional dynamic images of cardiac cycle of four-chamber, three-chamber, and two-chamber apex cordis were collected and stored, and Qlab 7.0 software was used for off-line analysis. Maximal systolic displacement（Ds） of mitral annulus in six sites, systolic displacement of the middle point（D-mid） and left ventricular longitudinal fractional shortening（FSL） were measured and calculated for mean value respectively, which were then used for correlation analysis with left ventricular ejection fraction（LVEF） measured by simplified dual plane Simpson. Results①Compared with control group, the mean value of Ds, D-mid and FSL of group A and B were significantly decreased, the difference of which was statistically significant（P〈0.05）. Compared with group A, the mitral annulus displacement parameters of group B decreased, the difference of which was statistically significant（P〈0.05）.②Compared the time used for the two measuring methods： TMAD technology significantly reduced the measuring time compared to the two-dimensional dual plane Simpson＇s method（P〈0.001）.③The mean values of Ds, D-mid and FSL in the control and coronary heart disease groups were all correlated with LVEF（r=0.77, 0.75, 0.78, P〈0.001; r=0.78, 0.79, 0.78, P〈0.001）.④Repeatability test： the intra-observer ICC values of the mean values of Ds, D-mid and FSL were 0.87, 0.85 and 0.93 respectively, and the inter-observer ICC values were 0.84, 0.84 and 0.88 respectively. Conclusion TMAD technology is time-saving, accurate and reproducible, which c

关 键 词：冠心病 超声心动描记术 多普勒 彩色 心室功能 左 二尖瓣 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]