实时三维斑点追踪成像及磁共振成像对2型糖尿病患者心室舒缩功能的评价  

Evaluation of real-time 3D-STI and MRI on ventricular systolic and diastolic function of T2DM patients

作　　者：付海杰[1] 王琪 王玥[1] Fu Haijie;Wang Qi;Wang Yue(CT Room,Daqing Longnan Hospital,Daqing 163451,China)

机构地区：[1]大庆龙南医院CT室,大庆163451

出　　处：《中国医学装备》2024年第4期60-65,共6页China Medical Equipment

基　　金：黑龙江省卫生健康委员会科研课题(2019-378)。

摘　　要：目的:探究实时三维斑点追踪成像(3D-STI)及磁共振成像(MRI)对2型糖尿病(T2DM)患者心室舒缩功能的评价。方法:选取2022年1月至2023年6月大庆龙南医院收治的100例T2DM患者,依据左心室射血分数(LVEF)水平将其分为≥50%组(62例)和<50%组(38例),比较不同LVEF患者3D-STI和MRI参数的差异,并比较3D-STI参数、MRI参数以及联合数据诊断T2DM患者心功能不全的效能。结果:LVEF<50%组患者的室间隔舒张末期厚度(IVsd)、左前降支(LAd)、左心室后壁舒张末期厚度(LVPWd)、全局面积应变(GAS)、全局纵向应变(GLS)及全局圆周应变(GCS)指标,以及左室收缩期容积(ESV)及右室收缩期容积(EDV)均高于LVEF≥50%组患者;二尖瓣口舒张期血流频谱A峰与E峰速度比值(E/A)、全局径向应变(GRS)、心搏量(SV)、射血分数(EF)及心排血量(CO)均低于LVEF≥50%组患者,差异有统计学意义(t=5.213、4.778、4.936、5.863、4.302、5.057、5.350、5.072、4.636、4.963、5.076、4.898、5.475,P<0.05)。二元logistic回归分析显示,IVsd、LAd、LVPWd、GAS、GLS、GCS、ESV及EDV为T2DM患者心功能不全的危险因素(OR=2.102、1.286、1.605、1.311、1.314、1.324、1.291、1.063,P<0.05),E/A、GRS、SV、EF及CO为T2DM患者心功能不全的保护因素(OR=0.008、0.823、0.813、1.850、0.201,P<0.05)。采用受试者工作特征(ROC)曲线分析获取MRI参数(SV、EF、ESV、EDV、CO)、3D-STI参数(IVsd、LAd、LVPWd、E/A、GRS、GAS、GLS、GCS)诊断T2DM患者心功能不全的ROC曲线下面积(AUC)分别为0.781、0.743、0.800、0.784、0.777、0.793、0.770、0.754、0.745、0.786、0.836、0.766和0.799。将MRI参数和3D-STI参数纳入logistic回归模型,联合数据诊断T2DM患者心功能不全的AUC为0.995,灵敏度为97.4%,特异度为98.4%。结论:MRI和3D-STI参数可评估T2DM患者心室舒缩功能,且联合数据诊断价值更好。Objective:To explore the evaluation of real-time three-dimensional speckle tracking imaging(3D-STI)and magnetic resonance imaging(MRI)on ventricular systolic and diastolic function of patients with type 2 diabetes mellitus(T2DM).Methods:A total of 100 T2DM patients admitted to Daqing Longnan Hospital from January 2022 to June 2023 were selected,and they were divided into≥50%group(62 patients)and<50%group(38 patients)based on the level of left ventricular ejection fraction(LVEF).The differences of 3D-STI and MRI parameters between different LVEF patients were compared,and the efficiencies of the 3D-STI parameter,MRI parameter and the combined data were also compared in diagnosing the cardiac insufficiency of T2DM patients.Results:The end-diastolic thickness of the interventricular septum(IVsd),left anterior descending branch(LAd),end-diastolic thickness of the posterior wall of the left ventricle(LVPWd),global area strain(GAS),global longitudinal strain(GLS),global circumferential strain(GCS),left ventricular systolic volume(ESV)and right ventricular systolic volume(EDV)in LVEF<50%group were respectively higher than those in LVEF≥50%group.The velocities of peak A and E of mitral valve diastolic blood flow spectrum(E/A),global radial strain(GRS),stroke volume(SV),ejection fraction(EF)and cardiac output(CO)in LVEF<50%group were significantly lower than those in LVEF≥50%group,and the differences were statistically significant(t=5.213,4.778,4.936,5.863,4.302,5.057,5.350,5.072,4.636,4.963,5.076,4.898,5.475,P<0.05),respectively.The binary logistic regression analysis showed that IVsd,LAd,LVPWd,GAS,GLS,GCS,ESV and EDV were risk factors for T2DM patients with cardiac insufficiency(OR=2.102,1.286,1.605,1.311,1.314,1.324,1.291,1.063,P<0.05),respectively,and E/A,GRS,SV,EF and CO were protective factors for T2DM patients with cardiac insufficiency(OR=0.008,0.823,0.813,1.850,0.201,P<0.05).The area under curve(AUC)values of receiver operating characteristic(ROC)curves of MRI parameter(SV,EF,ESV,EDV and CO)and 3D-STI param

关 键 词：2型糖尿病(T2DM) 三维斑点追踪成像(3D-STI) 磁共振成像(MRI) 心室舒缩功能 评价 

分 类 号：R445.2[医药卫生—影像医学与核医学]