基于超声三维斑点追踪成像检测川崎病患儿左心室整体应变及心肌纤维化  

Detection of global left ventricular strain and myocardial fibrosis in children with Kawasaki disease based on ultrasound three-dimensional speckle tracking imaging

作　　者：王建伟 焦丽华 刘小娜[2] 王红芳[1] 刘寅[1] 王晓青[1] WANG Jian-wei;JIAO Li-hua;LIU Xiao-na(The Department Of Pediatric cardiology;The Department Of Endocrine,Tangshan maternal and Child Health Hospital,Tangshan 063000,China)

机构地区：[1]唐山市妇幼保健院小儿心内科,河北唐山063000 [2]唐山市妇幼保健院小儿内分泌科,河北唐山063000

出　　处：《中国实验诊断学》2022年第12期1784-1787,共4页Chinese Journal of Laboratory Diagnosis

基　　金：唐山市卫健委项目(20221748)。

摘　　要：目的探究基于超声三维斑点追踪成像(3D-STE)检测川崎病患儿的左心室整体应变功能与心肌纤维化的相关性。方法纳入2018年12月至2021年12月唐山市妇幼保健院确诊并收治的72例川崎病(KD)患儿作为观察组,另选取同期健康体检者50例为对照组。两组均接受心脏磁共振成像(CMRI)检查及3D-STE检查,利用钆延迟强化(LGE)序列中的强化心肌信号阳性节段数评估心肌纤维化程度,以此将观察组分为无纤维化组(LGE阳性节段数=0)、轻度纤维化组(LGE阳性节段数为1~3)和重度纤维化组(LGE阳性节段数为>3),记录左心室心肌整体圆周应变(GCS)、整体径向应变(GRS)和整体纵向应变(GLS)。结果与对照组健康受检者相比,观察组患儿LVEF比较,差异均无统计学意义(P>0.05),GCS、GRS、GLS等心肌应变功能指标均明显低于对照组,差异均有统计学意义(P<0.05);观察组不同心肌纤维化严重程度亚组间比较,重度纤维化组和轻度纤维化组的GCS、GRS、GLS等心肌应变功能指标均明显低于无纤维化组,重度纤维化组的GCS、GRS、GLS等心肌应变功能指标均明显低于轻度纤维化组,差异均有统计学意义(P<0.05);发生心肌纤维化的KD患儿的GCS、GRS、GLS等心肌应变功能指标与LGE阳性节段数均呈负相关(P<0.05,r=-0.89、-0.77、-0.81)。结论3D-STE能快速准确地检测左心室心肌整体应变的改变,早期提示KD患儿存在心肌运动功能的损害,心肌运动功能的损害与心肌纤维化的严重程度具有一定相关性,有利于疾病的及时干预,值得进一步研究推广。Objective To explore the correlation between left ventricular global strain function and myocardial fibrosis in children with Kawasaki disease based on three-dimensional speckle tracking imaging(3 D-STE).Methods 72 children with Kawasaki disease(KD)diagnosed and treated in our hospital from December 2018 to December 2021 were included as the observation group,and 50 health examinees in the same period were selected as the control group.Both groups received cardiac magnetic resonance imaging(CMRI)and 3 D-STE examination.The degree of myocardial fibrosis was evaluated by the number of positive segments of enhanced myocardial signal in gadolinium delayed enhancement(LGE)sequence.The observation group was divided into non fibrosis group(LGE positive segments=0),mild fibrosis group(LGE positive segments=1-3),and severe fibrosis group(LGE positive segments>3).The overall circumferential strain(GCS)of left ventricular myocardium was recorded Global Radial Strain(GRS)and Global Longitudinal Strain(GLS).Results Compared with the healthy subjects in the control group,there was no significant difference in LVEF in the observation group(P>0.05),and the myocardial strain function indexes such as GCS,GRS,GLS were significantly lower than those in the control group,and the differences were all significant.Statistical significance(P<0.05).The myocardial strain function indexes such as GCS,GRS and GLS in the group were significantly lower than those in the non-fibrosis group,and the myocardial strain function indexes such as GCS,GRS and GLS in the severe fibrosis group were significantly lower than those in the moderate fibrosis group,and the differences were statistically significant.GCS,GRS,GLS and other myocardial strain function indexes of KD children with myocardial fibrosis were negatively correlated with the number of LGE positive segments(P<0.05,r=-0.89,-0.77,-0.81).Conclusion 3 D-STE can quickly and accurately detect the changes of the overall strain of the left ventricular myocardium,and early prompts the damage of myoc

关 键 词：川崎病 三维斑点追踪成像 超声心动图 心肌纤维化 心肌应变 

分 类 号：R725[医药卫生—儿科]