定量组织速度成像技术评价扩张型心肌病左室心肌功能的研究  

Assessment of Left Ventricular Function in Patients with Dilated Cardiomyopathy Using Quantitative Tissue Velocity Imaging

作　　者：王良玉[1] 谢明星[1] 王新房[1] 杨颖[1] 王静[1] 黄润青[1] 费洪文[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,武汉市430022

出　　处：《中国超声医学杂志》2004年第2期98-101,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的　探讨定量组织多普勒速度成像 (QTVI)技术评价扩张型心肌病 (DCM)患者左室心肌收缩与舒张功能的价值。方法　应用 QTVI获取 30例正常人和 30例 DCM患者左室长轴方向不同室壁节段即左室前壁、后壁、下壁、侧壁及室间隔的心肌多普勒速度曲线 ,分别比较以下参数 :1.正常人上述不同室壁中部心肌运动收缩期峰值速度 (Vs)、收缩期加速度 (a)、快速充盈期和心房收缩期的速度 (Ve和 Va)、收缩期内外膜峰值速度阶差 (MVG) ;2 .DCM患者不同左室壁中部的 Vs、Ve、Va、MVG、a的差异 ;3.正常人与 DCM患者左室壁中部的 Vs、Ve、Va、MVG、a的差异 ;4 .正常人与 DCM患者二尖瓣口舒张期血流频谱 E/ A值、左室射血分数 (L VEF)、 Vs/ Ve比值。结果　 (1) DCM患者 Vs、Ve、Va、MVG、a、L VEF均比正常人明显降低 ;(2 )以 a>6 5 cm/ s2、Vs/ Ve>0 .83作为判定患者心功能符合临床 NYHA分级 ～ 级、客观评分 A～ B级、L VEF>35 %的界定值 ,其敏感性 91% ,特异性 74 % ,阳性预测值 83%。结论　 QTVI定量评价 DCM患者左室心肌功能 ,为进一步了解 DCM患者局部心肌收缩舒张功能变化及其局部与整体心肌功能之间的关系提供较为敏感、精确的方法。Objective:This study was designed to assess the left ventricular(LV) regional systoic and diastolic function in patients with dilated cardiomyopathy using quantitative tissue velocity imaging QTVI.Methods:Thirty normal subjects and 30 DCM patients underwent QTVI study .Off-line LV regional velocity and displacement profiles along LV apical long-axis view were obtained synchronously?Peak tissue velocities of LV regional myocardium during systole(Vs),systolic acceleration(a),early diastole(Ve),LA contraction(Va),systolic velocity gradient(MVG) between endocardium and epicardium in the middle segments of LV,LV ejection fraction (LVEF) and mitral valve peak flow velocity E/A ratio were measured and compared between normal subject and DCM patients.Results:① Vs,Va,Ve,Vs/Ve,MVG,a and LVEF were significant reduced in DCM patients than those in normal subjects?② a>65 cm/s 2,Vs/Ve>0.83 can be used to yearly evaluating LV function (NYHA classⅠ～Ⅱ,Objective evaluating class A-B,LVEF>35%) in DCM patients with higher 91% sensitivity,74% specificity,and 83% postive predictive value.Conclusions:QTVI offers a newer method in clinical practice which has a higher sensitivity and accuracy in evaluating the LV regional systolic and diastolic function in DCM patients.

关 键 词：定量组织多普勒速度成像技术 扩张型心肌病 左室心肌功能 医学影像学 左室射血分数 

分 类 号：R445.1[医药卫生—影像医学与核医学]