实时三维超声及二维斑点追踪技术评价潜水员水肺潜水后右心室形态及收缩功能改变  

Real-time 3D echocardiography and 2D speckle tracking imaging in evaluation on right ventricular shape and systolic function changes in divers after scuba diving

作　　者：钱胜利[1] 杨莉[1] 刘畅 李延[1] 梅枭雄 QIAN Shengli;YANG Li;LIU Chang;LI Yan;MEI Xiaoxiong(Department of Special Diagnosis, Chinese PLA 161 Hospital, Wuhan 430010, China)

机构地区：[1]中国人民解放军第161医院特诊科

出　　处：《中国医学影像技术》2019年第8期1195-1199,共5页Chinese Journal of Medical Imaging Technology

基　　金：解放军超声医学专业委员会科研激励基金(JLJJ2016-005)

摘　　要：目的采用实时三维超声及二维斑点追踪技术评价潜水员水肺潜水后右心室形态及收缩功能改变。方法对60名健康潜水员于潜水前及潜水(佩戴自携式水下呼吸器恒温潜水,深度11m,时间60min)后即刻、1天、3天测量心率(HR)并行常规超声心动图检查,留存二维心尖四腔心及三维右心室容积动态图像,分别获得潜水前及潜水后各时间点右心室各径线及容积测值、右心室做功指数(RIMP)、右心室游离壁二维整体纵向应变[2DGLS(F)]、三尖瓣环收缩期位移(TAPSE)、右心室面积变化分数(FAC)、右心室三维射血分数(3DRVEF)及右心室游离壁三维整体纵向应变[3DGLS(F)]等指标。对潜水前后各指标进行统计学分析。结果潜水前、潜水后即刻、1天、3天之间,右心室中部横径、RIMP、右心室收缩末容积、每搏输出量、TAPSE及3DRVEF总体差异均无统计学意义(P均>0.05)。与潜水前比较,潜水后即刻HR、2DGLS(F)、FAC、3DGLS(F)均减低,右心室舒张末容积、右心室基底段横径、右心室长径均增大,差异均有统计学意义(P均<0.05);潜水后1天,2DGLS(F)、3DGLS(F)仍减低(P均<0.05),其他指标均恢复至潜水前水平(P均>0.05);潜水后3天上述各测量指标差异均无统计学意义(P均>0.05)。结论实时三维超声右心室容积定量及二维斑点追踪技术可反映潜水员潜水后短时间右心室形态及心肌收缩功能改变。Objective To observe changes of right ventricular shape and systolic function in divers after scuba diving with real-time 3D echocardiography and 2D speckle tracking imaging. Methods Recording of heart rate (HR) and conventional echocardiography were performed in 60 healthy divers before and immediately, 1 day, 3 days after scuba diving (wearing self-contained underwater respirator, constant temperature diving 11 m and 60 min), respectively, then 2D apical four-chamber heart and 3D right ventricular volumes dynamic images were stored. The right ventricle diameters and volume, right ventricle index of myocardial performance (RIMP), 2D global longitudinal strain of right ventricle free wall (2DGLS[F]), tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (FAC), 3D right ventricular ejection fraction (3DRVEF) and 3D global longitudinal strain of right ventricle free wall (3DGLS[F]) were obtained before and immediately, 1 day, 3 days after scuba diving. All the parameters were compared before and after scuba diving. Results There was no significant difference of right ventricle middle transverse diameter, RIMP, right ventricular systolic volume, stroke volume, TAPSE nor 3DRVEF before and immediately, 1 day, 3 days after scuba diving ( P >0.05). Compared with the results before scuba diving, HR, 2DGLS(F), FAC and 3DGLS(F) decreased, while right ventricular end diastolic volume, right ventricular base transverse diameter and right ventricular long axis diameter increased immediately after scuba diving (all P <0.05). One day later, 2DGLS(F) and 3DGLS(F) still decreased (all P <0.05), the other parameters all restored to pre-dive level (all P >0.05). Three days later, there was no significant difference of the above parameters ( P >0.05). Conclusion After scuba diving, right ventricular shape and systolic function of divers can slightly change in a short term, which can be sensitively observed with real-time 3D echocardiography of RV volume quantification analysis and 2D speckle tr

关 键 词：心室功能 右 超声心动图描记术 潜水 斑点追踪 形态 

分 类 号：R3[医药卫生—基础医学] R540.45