刘晗,刘安宁,李玉宏.XPLANE技术评价经皮介入封堵房间隔缺损前后右心室功能[J].中国医学影像技术,2020,36(6):844~848
XPLANE技术评价经皮介入封堵房间隔缺损前后右心室功能
XPLANE technique for evaluation on right ventricular function of atrial septal defect patients before and after percutaneous intervention
投稿时间:2019-06-11  修订日期:2020-02-17
DOI:10.13929/j.issn.1003-3289.2020.06.009
中文关键词:  心脏缺损,先天性  心室功能,右  介入治疗  超声检查
英文关键词:heart defects, congenital  ventricular function, right  interventional therapy  ultrasonography
基金项目:辽宁省自然科学基金(20170540381)、辽宁省兴辽英才计划(XLYC1802049)。
作者单位E-mail
刘晗 锦州医科大学附属第一医院超声科, 辽宁 锦州 121001  
刘安宁 锦州医科大学附属第一医院超声科, 辽宁 锦州 121001  
李玉宏 锦州医科大学附属第一医院超声科, 辽宁 锦州 121001 yuhong_jiahui@163.com 
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中文摘要:
      目的 探讨采用XPLANE技术测量右心室纵向缩短分数(LSF)评估经皮介入封堵(PI)房间隔缺损(ASD)前后右心室功能变化的应用价值,分析及其影响因素。方法 收集68例经超声检查诊断ASD并接受PI患者,分别于术前及术后1、3个月行超声心动图检查,采用XPLANE技术测量并比较其二腔心切面(LSFAP2)和四腔心切面(LSFAP4)图像LSF及其均值(LSFAPM)、三尖瓣环收缩期位移(TAPSE)、肺动脉高压(PH)分级、右心室与左心室舒张末期内径比(RVEDD/LVEDD)分级的差异;分析LSFAP2、LSFAP4、LSFAPM与TAPSE的相关性及LSFAPM的影响因素。结果 术后1、3个月RVEDD/LVEDD(H=76.07、77.74)及PH分级(H=42.02、49.83)均较术前降低(P均<0.05)。3个时间点之间右心室LSFAP2、LSFAP4、LSFAPM及TAPSE差异均有统计学意义(F=6.11、3.18、8.35、20.28,P均<0.05);术前与术后3个月LSFAP4、LSFAPM差异无统计学意义(P均>0.05),LSFAP2、LSFAP4、LSFAPM及TAPSE两两比较差异均有统计学意义(P均<0.05)。PI前后LSF参数均与TAPSE呈正相关(P均<0.05)。年龄、术前PH分级为LSFAPM的共同影响因素。结论 利用XPLANE技术可有效观察ASD患者PI前后右心室功能变化。PI术后ASD患者右心室形态及功能均获改善,且术前及术后LSF参数与TAPSE变化趋势基本一致。年龄和术前PH分级为ASD患者右心功能的影响因素。
英文摘要:
      Objective To explore the application value of right ventricular longitudinal shortening fraction (LSF) obtained with XPLANE technique for evaluation on changes of right ventricular function in patients with atrial septal defect (ASD) before and after percutaneous intervention (PI), and to analyze relative impact factors. Methods Totally 68 patients with ultrasound-diagnosed ASD who accepted PI were collected. All patients underwent echocardiography before PI, 1 month and 3 months after PI, respectively. Then LSF of apical plane of 2-chamber (LSFAP2) and apical plane of 4-chamber (LSFAP4) images and the mean value of LSFAP2 and LSFAP4 (LSFAPM), tricuspid annular plane systolic excursion (TAPSE), pulmonary hypertension (PH) grading, as well as right ventricle end-diastolic diameter/left ventricle end-diastolic diameter (RVEDD/LVEDD) grading before and after PI were measured and compared. The correlation of LSFAP2, LSFAP4, LSFAPM and TAPSE, and the impact factors of LSFAPM were analyzed. Results RVEDD/LVEDD (H=76.07, 77.74) and PH (H=42.02, 49.83) grading 1 month and 3 months after PI were lower than those before PI (all P<0.05). There were statistical differences of LSFAP4, LSFAP2, LSFAPM and TAPSE in right ventricle before and after PI (F=6.11, 3.18, 8.35, 20.28, all P<0.05). NO statistical difference was found between LSFAP4 and LSFAPM before PI nor those after PI (both P>0.05). There were statistical differences of remaining LSFAP2, LSFAP4, LSFAPM and TAPSE before and after PI (all P<0.05). LSF parameters before and after PI were positively correlated with TAPSE (all P<0.05).Age and preoperative PH grading were the common impact factors of LSFAPM before and after PI. Conclusion XPLANE technique can be used to effectively observe the changes of right ventricular function in patients with ASD before and after PI. The morphology and function of right ventricle in patients can be improved with PI, and the variation trend of LSF parameters and TAPSE before and after PI are basically similar. Age and preoperative PH grading are impact factors of right heart function before and after PI.
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