三维斑点追踪技术评价左前降支心肌桥患者左心收缩功能的价值  

Evaluation of 3-dimensional speckle tracking imaging on left ventricular systolic function in patients with myocardial bridge on the left anterior descending artery

作　　者：徐升 黄朴忠 姜艳娜 XU Sheng;HUANG Pu-zhong;JIANG Yanna

机构地区：[1]辽宁省金秋医院

出　　处：《中国实用医药》2020年第2期19-21,共3页China Practical Medicine

摘　　要：目的探讨采用三维斑点追踪技术(3D-STI)评价左前降支心肌桥患者左心收缩功能的价值。方法 79例经冠状动脉造影确诊为左前降支心肌桥患者,根据收缩期狭窄程度将心肌桥分为三组,<50%为NobleⅠ级组(23例);50%~75%为NobleⅡ级组(28例);≥75%为NobleⅢ级组(28例),选取同期体检健康者30例作为对照组。采用三维超声斑点追踪技术,观察比较各组三维心肌应变值[纵向收缩峰值应变(rLS)、整体纵向收缩峰值应变(GLS)、径向收缩峰值应变(rRS)、整体径向收缩峰值应变(GRS)、圆周向收缩峰值应变(rCS)、整体圆周向收缩峰值应变(GCS)、节段面积应变(RAS)、整体面积应变(GAS)]及三维左心室射血分数(3DLVEF)水平。结果四组3DLVEF水平比较,差异无统计学意义(P>0.05);NobleⅡ级组和NobleⅢ级组患者左心室整体及左前降支供血节段的r LS、GLS、RAS、GAS低于对照组和NobleⅠ级组,且NobleⅢ级组患者低于NobleⅡ级组患者,差异具有统计学意义(P<0.05);四组rRS、GRS、rCS、GCS比较,差异无统计学意义(P>0.05)。应变值与壁冠状动脉收缩期狭窄程度呈负相关, RS(r=-0.35, P<0.05)、CS(r=-0.37, P<0.05)、LS(r=-0.45, P<0.05),其中AS(r=-0.88, P<0.05)呈显著性负相关。结论实时三维斑点追踪技术需要较高的图像质量来获得三维空间各个方向的心肌应变值。所需的全容积数据受多种因素的影响,如心率、呼吸频率以及图像分析时心内膜勾画的准确性。其次,实时三维斑点追踪技术的时间和空间分辨率较低,有可能导致心肌应变率的低估。Objective To discuss the value of left ventricular systolic function in patients with myocardial bridge on the left anterior descending artery by 3-dimensional speckle tracking imaging(3D-STI). Methods A total of 79 patients with myocardial bridge on the left anterior descending artery diagnosed by coronary angiography were divided into Noble group Ⅰ(23 cases, <50%), Noble grade Ⅱ group(28 cases, 50%~75%) and Noble grade Ⅲ group(28 cases, ≥75%) by degree of systolic stenosis. Another 30 healthy persons in the same period were selected as the control group. According to 3-dimensional speckle tracking imaging, 3-dimensional myocardial strain value [regional longitudinal strain(rLS), global longitudinal strain(GLS), regional radial strain(rRS), global radial strain(GRS), regional circumferential strain(rCS), global circumferential strain(GCS), regional area strain(RAS), global area strain] and 3-dimensional left ventricular ejection fraction(3DLVEF) level was observed and compared among the three groups. Results There was no statistically significant difference in 3DLVEF level among four groups(P>0.05). The rLS, GLS, RAS and GAS of the whole left ventricle and the blood supply segment of left anterior descending artery in Noble grade Ⅱ group and Noble grade Ⅲ group was lower than those in the control group and Noble grade Ⅰ group, and their difference was statistically significant(P<0.05). There was no statistically significant difference in rLS, GLS, RAS and GAS among four groups(P>0.05). There was a negative correlation between the strain value and the degree of systolic stenosis of the coronary artery, RS(r=-0.35, P<0.05), CS(r=-0.37, P<0.05), LS(r=-0.45, P<0.05), and AS(r=-0.88, P<0.05) showed a significant negative correlation. Conclusion The real-time 3-dimensional speckle tracking imaging needs high image quality to obtain the myocardial strain values in all directions of 3-dimensional space. The required full volume data is affected by many factors, such as heart rate, respiratory rate and the

关 键 词：心肌桥 左前降支 三维斑点追踪技术 左心收缩功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.1[医药卫生—诊断学]