超声分层应变成像技术对阿霉素致大鼠急性左心室心肌早期毒性损伤的评价  

Assessment of early doxorubicin-induced early-stage acute myocardial toxicity in rats using ultrasonic left ventricular myocardial layer-specific strain imaging

作　　者：蔡璐 尹立雪[2] 王斯佳[2] 周婕 徐芸 郭智宇 Cai Lu;Yin Lixue;Wang Sijia;Zhou Jie;Xu Yun;Guo Zhiyu(Clinical Medicine Academy,Southwest Medical University,Luzhou 646000,China;Key Laboratory of Ultrasound in Cardiac Electrophysiology and Bio-mechanics of Sichuan Province,Institute of Ultrasound in Medcine,Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital,Chengdu 610072,China)

机构地区：[1]西南医科大学临床医学院,泸州646000 [2]四川省医学科学院·四川省人民医院超声医学研究所,超声心脏电生理学与生物力学四川省重点实验室,成都610072 [3]通用电气医疗超声临床心血管应用部,611731

出　　处：《中华医学超声杂志（电子版）》2019年第5期386-392,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：四川省科技厅项目(2016TD0017,2017TD0015)

摘　　要：目的应用二维超声斑点追踪成像(2D-STI)分层应变技术,评价阿霉素致大鼠急性左心室心肌早期毒性损伤的特点。方法选取体质量300~350g SD雄性大鼠32只,完全随机分为阿霉素组和空白对照组,每组各16只。阿霉素组:采用浓度2mg/ml盐酸阿霉素,按12mg/kg给药剂量一次性腹腔注射。空白对照组:给予同等容量的0.9%氯化钠溶液一次性腹腔注射。应用常规二维灰阶采集给药前、给药后24h和给药后48h3个时间点的左心室短轴乳头肌水平的超声心动图像,采用解剖M型超声技术测量左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD),以及测量舒张末期室间隔(IVSd)、左心室后壁(LVPWd)厚度,计算左心室短轴缩短率(FS)和左心室射血分数(LVEF)。应用基于二维超声斑点追踪成像工作站心肌分层应变分析技术获取左心室乳头肌水平短轴切面心肌整体圆周分层应变值,比较两组大鼠3个时点的左心室FS、EF测值及左心室乳头肌水平短轴切面心内膜下心肌、中层心肌、心外膜下心肌3层圆周应变差异。完成3个时间点超声心动图检查后,两组各随机处死3只大鼠,取大鼠心脏行HE染色行常规心肌病理学检查。组内给药后24h、48h数据与给药前数据比较采用配对t检验,组间给药前数据比较采用成组t检验。结果两组大鼠左心室短轴乳头肌水平整体圆周分层应变值分布均存在梯度特征:心内膜下心肌>中层心肌>心外膜下心肌。阿霉素组大鼠左心室乳头肌水平短轴心内膜下心肌圆周应变在给药48h后减低。与给药前相比,差异有统计学意义(-25.13±10.6vs -17.04±2.89,t=2.3,P<0.05);对照组大鼠左心室乳头肌水平短轴切面三层心肌圆周应变参数及阿霉素组大鼠左心室乳头肌水平短轴切面中层心肌及心外膜下心肌圆周应变参数在给药前后3个时点比较,差异均无统计学意义(P均>0.05)。LVEDD、LVESD、IVSd、LVPWd、FS、LVEF�Objective To evaluate the transmural myocardial strain in three specific layers of the left ventricle at the papillary muscle level in short-axis view in SD rats before and after doxorubicin administration using myocardial layer-specific strain imaging based on two-dimensional ultrasound speckle tracking imaging (2D-STI),and to demonstrate the myocardial mechanical characteristics of doxorubicininduced early-stage acute cardiac toxicity in rats.Methods Thirty-two SD male rats weighing 300-350 g were randomly divided into a doxorubicin group (DOX group,n=16) and a control group (n=16).In the doxorubicin group,doxorubicin hydrochloride (concentration,2 mg/ml) was injected intraperitoneally at a single dose of 12 mg/kg,while the control group was given equal volume of 0.9% sodium chloride solution.LVEDD,LVESD,IVSd,LVPWd,FS,and LVEF were measured and derived using two-dimensional gray-scale echocardiography at the left ventricular papillary muscle level in short-axis view at three time points (before administration and 24 and 48 hours after administration).The circumferential strain in the subendocardium,medium,and subepicardium at the left ventricular papillary muscle level in short-axis view were obtained using ultrasonic 2D-STI.The values of FS,LVEF,and the global myocardial circumferential strain in different layers of the left ventricular wall at the papillary muscle level in short axis view at three time points were compared between the two groups.After echocardiographic examinations at 48 h and 72 h,the hearts of three rats in each group were randomly selected,sliced,and HE-stained for myocardial pathological observation.Results In both groups,there was a circumferential strain gradient of the left ventricular wall at the papillary muscle level in the short-axis view:subendocardium > medium > epicardial myocardium.In the DOX group,the circumferential strain in the subendocardial myocardium decreased at 48 hours after DOX administration;the difference was statistically significant between the two groups (-25.13

关 键 词：超声检查 分层应变 大鼠 

分 类 号：R445.1[医药卫生—影像医学与核医学]