多模态超声对右心结构和功能的评估研究  

Evaluation of structure and function of right ventricular by multimodal ultrasound

作　　者：贾琼玮 贾利平[1] 张磊磊 袁颜颜 JIA Qiongwei;JIA Liping;ZHANG Leilei;YUAN Yanyan(Department of Ultrasonography,Yiwu Center Hospital,Yiwu 322000,China)

机构地区：[1]义乌市中心医院超声科,322000

出　　处：《浙江医学》2024年第13期1391-1395,共5页Zhejiang Medical Journal

基　　金：义乌市科技局项目(22-3-21)。

摘　　要：目的运用多模态超声检查技术进行右心室结构和功能的综合评估,为右心相关的疾病诊治提供更客观、高效的超声检测工具。方法前瞻性收集2022年2月至2023年2月义乌市中心医院诊治右心相关疾病的患者88例(观察组)和健康志愿者80名(对照组),采用常规二维超声测量三尖瓣环收缩期位移(TAPSE)、三尖瓣环收缩期速度(S')和右心室面积变化分数(FAC)、三尖瓣口舒张早期与晚期血流峰值速度的比值(E/A)、右心房内径(RAD)、下腔静脉内径及吸气末内径塌陷率,二维斑点追踪技术(2D-STE)测量右心室游离壁心肌整体纵向应变(RVGLS),实时三维超声(RT-3DE)测量右心室射血分数(RVEF)。结果观察组TAPSE、S'、FAC、E/A和RVEF明显低于对照组,RVGLS高于对照组(均P<0.05)。Spearman秩相关显示,RVGLS与TAPSE、S'、FAC、E/A和RVEF均呈负相关,RVEF与TAPSE、S'、FAC和E/A均呈正相关(均P<0.05)。最后,TAPSE、S'、FAC、E/A、RVEF和RVGLS的观察者内和观察者间的组内相关系数均≥0.899(均P<0.05),提示多模态超声的重复性较好。结论综合应用多模态超声技术能够提供更多有关右心室结构和功能的信息,在客观、准确诊治右心相关疾病方面具有重要的应用价值。Objective To evaluate the structure and function of right ventricle using multimodal ultrasound technology.Methods A total of 88 patients with right heart diseases who underwent ultrasonographic examination in Yiwu Center Hospital from February 2022 to February 2023 were enrolled(study group),and 80 healthy subjects were selected as the control group.The tricuspid annular plane systolic excursion(TAPSE),tissue Doppler tricuspid annular systolic velocity(S')and right ventricular fractional area change(FAC),the ratio of early and late tricuspid diastolic peak velocity(E/A),right atrial diameter(RAD),inferior vena cava diameter and end-inspiratory collapse rate were measured by conventional twodimensional echocardiography;the global longitudinal strain of right ventricular free wall myocardium(RVGLS)was measured by two-dimensional speckle tracking technique echocardiography(2D-STE);and the right ventricular ejection fraction(RVEF)was measured by real-time three-dimensional echocardiography(RT-3DE).Results Compared to the control group the TAPSE,S',FAC,E/A and RVEF values in the study group decreased,while RVGLS increased(all P<0.05).Spearman test showed that RVGLS was negatively correlated with TAPSE,S',FAC,E/A and RVEF,while RVEF was positively correlated with TAPSE,S',FAC and E/A(all P<0.05).Finally,inter-group correlation coefficients(ICC)of TAPSE,S',FAC,E/A,RVEF and RVGLS between intra-group and inter-group were greater than 0.899(all P<0.05),suggesting that multimodal ultrasound had good repeatability.Conclusion The comprehensive application of multimodal ultrasound technology can provide more information about the structure and function of right ventricle for accurate diagnosis and treatment of right heart diseases.

关 键 词：多模态超声 二维斑点追踪技术 实时三维超声心动图 右心室 右心室整体纵向应变 右心室射血分数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R54[医药卫生—诊断学]