多普勒组织成像评价冠心病患者右室壁运动的初步研究  

The Value of Pulse-wave Doppler Tissue Imaging in Studying the Motion of Right Ventricular Wall on Patients with Coronary Artery Diseases

作　　者：程蕾蕾[1] 舒先红[1] 谭德英[2] 沈学东[1] 葛均波[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院上海市心血管病研究所,上海市200032 [2]长春市长春中医学院附属医院电诊科,吉林省130021

出　　处：《中国超声医学杂志》2002年第9期662-665,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :对正常组、右冠状动脉狭窄组和左冠状动脉狭窄组右室游离壁不同节段行 DTI检查 ,定性和定量评价冠心病患者右室壁运动 ,并探讨其临床意义和价值。方法 :分别对 A组 12例正常对照者、 B组 15例右冠状动脉狭窄者和 C组 7例左冠状动脉狭窄者的心尖四腔心切面右室游离壁基底段、中段和心尖段以及左室游离壁基底段行 DTI检查 ,测量其 S、 S- VTI、 E、 A、 Q- E、 Q- Ep,并对比分析。结果 :B组基底段的 S、 S- VTI、 E和中段的 S,C组基底段的 S、 S- VTI、 E均低于 A组 ,其中 B组基底段的 S较 A组显著减小 (P=0 .0 0 4 7) ;B组基底段的Q- E、 Q- Ep、中段的 Q- Ep较 A组延长。证明冠状动脉病变确实影响了右室壁的运动功能 ,右室游离壁的 DTI测量值和右冠状动脉病变相关。而且 ,左冠状动脉的病变也会影响右室壁的运动功能。结论 :DTI可用于评价冠心病患者右室壁的运动异常。心尖四腔心切面右室游离壁基底段的 S能特异评价右冠状动脉病变。Objective:To validate the feasibility and diagnostic accuracy of the motion of right ventricular wall on patients with coronary artery diseases.Methods:The study population included 34 consecutive patients performed coronary angiography recently.All patients were devided into 3 groups according to the narrowing position and its degree.Group A included 12 patients with normal results of coronary angiography,Group B,15 patients with their right coronary narrowing(≥70% diameter stenosis)and Group C,7 patients with their left coronary narowing(≥70% diameter stenosis).DTIs of RV free walls close to the tricuspid annulus and the middle apical and free LV walls close to the mitral annulus were performed.The maximum velocity(S)and the velocity integral(VTI S)during the ejection phase,the maximum velocity during the early(E),and late(A)diastole,the time interval from the onset of QRS wave of the EKG to the emergy of E(Q E)and the peak diastolic velocity(Q Ep)were measured.Results:In group B,close to the tricuspid annulus of RV free walls,S?S VTI and E were lower than in group A,Q E and Q Ep were delayed.In group C,Close to the tricuspid annulus of RV free walls,S?S VTI and E were lower than in group A.Close to the tricuspid annulus of RV free walls,there was a significant difference of S between group A and B( P =0 0047).These results were related to those of coronary angiography.Conclusions:The main findings of our study were the abnormal motion of the free walls of RV which could be detected by DTI with high feasibility.DTI has enormous potentialities for evaluating the whole and regional RV function.The decrease of S close to the tricuspid annulus of RV free walls would be a new index for diagnosis of abnormal right coronary artery.

关 键 词：多普勒组织成像 冠心病 右室壁运动 诊断 

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