VRM与2D-STI、3D-STI技术和RT-3DE在评价左室径向非同步化的一致性研究  

Study on the consistency among VRM with 2D-STI, 3D-STI and RT-3DE in evaluating dyssynchrony of left ventricular radial

作　　者：刘怡 董云[2] 陈明[2] 高雅琦[1] 王坚锋[1] 吴明烨[1] LIU Yi;DONG Yun;CHEN Ming(Department of Ultrasound,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院超声科,上海200021 [2]上海同济大学附属东方医院超声科,上海200120

出　　处：《中国医学装备》2019年第12期65-68,共4页China Medical Equipment

基　　金：上海市卫生和计划生育委员会科研课题计划(201440335)“动态全景M型(vRM)对左室径向非同步化的应用研究”

摘　　要：目的:探究应用动态全景M型(VRM)与二维、三维斑点追踪成像(2D-STI和3D-STI)技术,实时三维超声心动图(RT-3DE)在评估左室径向非同步化一致性。方法:回顾性选取医院收治的73例心脏同步(CRT)植入Ⅰ类适应证慢性心衰患者资料,将其纳入观察组,另选同期进行体检的65名健康者相关检查资料,将其纳入健康对照组。两组均接受VRM、2D-STI、3D-STI及RT-3DE相关检查,并进行其影像资料分析。比较两组VRM、2D-STI、3D-STI、RT-3DE相关参数,评估VRM与2D-STI、3D-STI及RT-3DE对左室径向非同步化定量评价的一致性。结果:心衰患者360°应变达峰时间标准差(Ts360-SD)、360°应变达峰时间最大差值(Ts360-dif)、应变达峰时间标准差(Ts-SD)、应变达峰时间最大差值(Ts-dif)、收缩不同步指数(SDI)、左心室16节段容积达到最小值时和R波之间的时间差的标准差(Tmsv-16SD%)、左心室16节段容积达到最小值时和R波之间的时间差的最大差值(Tmsv-16dif%)均显著高于对照组,差异有统计学意义(t=79.871,t=17.862,t=16.758,t=9.532,t=17.893,t=24.505,t=13.050;P<0.05);Bland-Altman检验结果显示,VRM与2D-STI、3D-STI及RT-3DE测得左室径向非同步化参数一致性较好。结论:VRM在与2D-STI、3D-STI和RT-3DE评价左室径向非同步化方面一致性较好,临床应用价值高。Objective:To explore the consistency of virtual reality mode(VRM)of whole scene M mode on dynamic state with two-dimensional speckle tracking imaging(2D-STI)technique,three-dimensional speckle tracking imaging(3D-STI)technique and real-time 3D echocardiography(RT-3DE)in evaluating dyssynchrony of left ventricular radial.Methods:The data of 73 patients with chronic heart failure and type I indications of cardiac resynchronization therapy(CRT)who received treatment in hospital were retrospectively selected and were divided into observation group,and the relevant examination data of 65 healthy people who received physical examination were divided into healthy control group.All the subjects underwent VRM,2D-STI,3D-STI and RT-3DE examinations and their image data were further analyzed.The associated parameters of VRM,2D-STI,3D-STI and RT-3DE between two groups were compared.The consistencies of VRM with 2D-STI,3D-STI and RT-3DE for quantitative evaluation of the dyssynchrony of left ventricular radial was assessed.Results:360°time strain-standard deviation(Ts360-SD),360°time strain-difference(Ts360-dif),time strain-standard deviation(Ts-SD),time strain-difference(Ts-dif),systolic dyssynchrony index(SDI),the minimum correction value of 16 segments up to minimum volume standard deviation(Tmsv-16SD)%and the minimum correction value of 16 segments up to minimum volume difference(Tmsv-16dif%)of observation group were significantly higher than those of healthy control group(t=79.871,t=17.862,t=16.758,t=9.532,t=17.893,t=24.505,t=13.050,P<0.05).Bland-Altman test results showed that the consistency of VRM with 2D-STI,3D-STI and RT-3DE was better.Conclusion:VRM has better consistency with 2D STI,3D STI and RT-3DE in evaluating dyssynchron of left ventricular radial,and it has higher application value in clinical practice.

关 键 词：动态全景M型 二维和三维 斑点追踪成像(STI) 实时三维超声心动图(RT-3DE) 左室径向 非同步化 一致性 

分 类 号：R445.1[医药卫生—影像医学与核医学]