超声斑点追踪技术测量心肌缺血患者二维应变的临床研究(1)
[摘要]目的 應用超声斑点追踪技术(STI)测量心肌缺血患者左室心肌纵向应变，探讨二维纵向应变检测心肌缺血的临床价值。方法 选择我院2017年1月～2018年12月收治的经超声心动图检查后又行冠状动脉造影检查的患者共50例作为观察组。另选择同期健康体检接受二维超声检查者50例作为对照组，用二维应变软件分析心尖长轴观、心尖两腔和四腔观的图像，测量心率、左室舒张末内径(LVEDD)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)及左室射血分数(LVEF)及舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值(E/A);应用Simpson′s 双平面测量法，测量左右心室舒张末期(EDV)、收缩末期(ESV)容积、心搏出量(SV)，获得均值。然后进行图像的采集，包括记录持续稳定的3个心动周期的动态图像，然后进行数据分析。比较分析左室18节段纵向应变值(SL 18，包含心尖6节段)和左室12节段纵向应变值(SL 12，不含心尖6节段)的诊断价值。结果 观察组LVEDD和LVEDV高于对照组，舒张期二尖瓣口频谱E/A低于对照组，差异均有统计学意义(P<0.05);观察组和对照组的心尖部6节段纵向应变值(SL 6A)均高于基底部6节段(SL 6S)和中间部6节段(SL 6M)纵向应变值，差异有统计学意义(P<0.05);SL 18诊断心肌缺血的特异性低于SL 12，差异有统计学意义(P<0.05)。结论 超声斑点追踪技术能对心肌的二维应变进行客观、定量分析，为临床诊断心肌缺血、评价心肌功能提供了一种无创性新方法。
[关键词]超声;心肌缺血;心室功能;斑点追踪技术
[中图分类号] R455.1 [文献标识码] A [文章编号] 1674-4721(2019)12(a)-0111-03
Clinical study of ultrasonic speckle tracking imaging in measuring two-dimensional strain in patients with myocardial ischemia
WANG Wei SONG Zhan-chun ZHENG Hong
Department of Ultrasound， Fushun Central Hospital， Liaoning Province， Fushun 113006， China
[Abstract] Objective To measure the longitudinal strain of left ventricle myocardium in patients with myocardial ischemia by ultrasonic speckle tracking imaging (STI)， and to explore the clinical value of two-dimensional longitudinal strain detection of myocardial ischemia. Methods A total of 50 patients who underwent coronary angiography after echocardiography admitted to our hospital from January 2017 to December 2018 were enrolled as the observation group. Another 50 participants who underwent two-dimensional ultrasound examination in the same period were selected as the control group. Two-dimensional strain software was used to analyze the apical long axis view， apical two-chamber and four-chamber view images. The heart rate and left ventricular end diastolic diameter (LVEDD)， left ventricular end-diastolic volume (LVEDV)， left ventricular end-systolic volume (LVESV)， and left ventricular ejection fraction (LVEF)， and early diastolic mitral flow velocity versus advanced diastolic mitral flow velocity (E/A) were measured. Simpson′s biplane measurement was used to measure left and right ventricular end-diastolic volume (EDV) and end-systolic volume (ESV)， and stroke output (SV)， and their mean values were obtained. After that， the image acquisition was performed including recording a dynamic image of three consecutive cardiac cycles and then performing data analysis. The diagnosis value of left ventricular 18 segment longitudinal strain (SL 18， including 6 apical segments) and left ventricular 12 segment longitudinal strain (SL 12， excluding 6 apical segments) were compared. Results The LVEDD and LVEDV in the observation group were higher than those in the control group， the differences were statistically significant (P<0.05). The diastolic mitral valve spectrum E/A in the observation group was lower than that of the control group， the difference was statistically significant (P<0.05). The 6 apical segments longitudinal strain (SL 6A) of the observation group and the control group were higher than the 6 basal (SL 6S) and 6 middle (SL 6M) segments longitudinal strain， the differences were statistically significant (P<0.05). The specificity of SL 18 diagnosis for myocardial ischemia was lower than that of SL 12， the differences were statistically significant (P<0.05). Conclusion Ultrasonic STI can conduct an objective and quantitative analysis on the two-dimensional strain of myocardium， which provides a non-invasive new method for clinical diagnosis of myocardial ischemia and evaluation on myocardial function., http://www.100md.com(王薇 宋占春 郑宏)
[关键词]超声;心肌缺血;心室功能;斑点追踪技术
[中图分类号] R455.1 [文献标识码] A [文章编号] 1674-4721(2019)12(a)-0111-03
Clinical study of ultrasonic speckle tracking imaging in measuring two-dimensional strain in patients with myocardial ischemia
WANG Wei SONG Zhan-chun ZHENG Hong
Department of Ultrasound， Fushun Central Hospital， Liaoning Province， Fushun 113006， China
[Abstract] Objective To measure the longitudinal strain of left ventricle myocardium in patients with myocardial ischemia by ultrasonic speckle tracking imaging (STI)， and to explore the clinical value of two-dimensional longitudinal strain detection of myocardial ischemia. Methods A total of 50 patients who underwent coronary angiography after echocardiography admitted to our hospital from January 2017 to December 2018 were enrolled as the observation group. Another 50 participants who underwent two-dimensional ultrasound examination in the same period were selected as the control group. Two-dimensional strain software was used to analyze the apical long axis view， apical two-chamber and four-chamber view images. The heart rate and left ventricular end diastolic diameter (LVEDD)， left ventricular end-diastolic volume (LVEDV)， left ventricular end-systolic volume (LVESV)， and left ventricular ejection fraction (LVEF)， and early diastolic mitral flow velocity versus advanced diastolic mitral flow velocity (E/A) were measured. Simpson′s biplane measurement was used to measure left and right ventricular end-diastolic volume (EDV) and end-systolic volume (ESV)， and stroke output (SV)， and their mean values were obtained. After that， the image acquisition was performed including recording a dynamic image of three consecutive cardiac cycles and then performing data analysis. The diagnosis value of left ventricular 18 segment longitudinal strain (SL 18， including 6 apical segments) and left ventricular 12 segment longitudinal strain (SL 12， excluding 6 apical segments) were compared. Results The LVEDD and LVEDV in the observation group were higher than those in the control group， the differences were statistically significant (P<0.05). The diastolic mitral valve spectrum E/A in the observation group was lower than that of the control group， the difference was statistically significant (P<0.05). The 6 apical segments longitudinal strain (SL 6A) of the observation group and the control group were higher than the 6 basal (SL 6S) and 6 middle (SL 6M) segments longitudinal strain， the differences were statistically significant (P<0.05). The specificity of SL 18 diagnosis for myocardial ischemia was lower than that of SL 12， the differences were statistically significant (P<0.05). Conclusion Ultrasonic STI can conduct an objective and quantitative analysis on the two-dimensional strain of myocardium， which provides a non-invasive new method for clinical diagnosis of myocardial ischemia and evaluation on myocardial function., http://www.100md.com(王薇 宋占春 郑宏)