蒋海波,王韦,奚佳颖,汤佳美,陈恺蓓,王凌霄,金修才,沈若宇.三维斑点追踪成像(3D-STE)定量评价容量负荷改变后左心室整体应变情况[J].中国医学影像技术,2022,38(7):1008~1012
三维斑点追踪成像(3D-STE)定量评价容量负荷改变后左心室整体应变情况
Three-dimension speckle tracking echocardiography (3D-STE) for quantitatively evaluating overall strain of left ventricular under changed volume load
投稿时间:2022-01-25  修订日期:2022-04-09
DOI:10.13929/j.issn.1003-3289.2022.07.010
中文关键词:  心室功能,左  应变  容量负荷  超声心动描记术,三维  斑点追踪成像
英文关键词:ventricular function,left  strain  volume load  echocardiography,three-dimensional  speckle tracking imaging
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作者单位E-mail
蒋海波 海军军医大学第一附属医院超声科, 上海 200433  
王韦 海军军医大学第一附属医院超声科, 上海 200433  
奚佳颖 海军军医大学第一附属医院超声科, 上海 200433  
汤佳美 海军军医大学第一附属医院超声科, 上海 200433  
陈恺蓓 海军军医大学第一附属医院超声科, 上海 200433  
王凌霄 海军军医大学第一附属医院超声科, 上海 200433  
金修才 海军军医大学第一附属医院超声科, 上海 200433 goldenxc@126.com 
沈若宇 海军军医大学第一附属医院超声科, 上海 200433  
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中文摘要:
       目的 采用三维斑点追踪成像(3D-STE)定量评价容量负荷改变后左心室整体应变情况。方法 选取动脉导管未闭(PDA)患者(PDA组)、继发型房间隔缺损(ASD)患者(ASD组)及健康体检者(对照组)各35人,分析其常规超声及3D-STE资料;比较组间左心室舒张末期内径(LVEDD)、收缩末期内径(LVESD)、后壁舒张末期厚度(LVPWT)、室间隔厚度(IVST)、左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、射血分数(LVEF)、肺动脉内径(PAD)、肺动脉收缩压(PAP)、左心室整体纵向/圆周/径向/面积应变(GLS/GCS/GRS/GAS),观察PDA及ASD组左心室GAS的影响因素;评估3D-STE评价左心室容量负荷改变后其三维整体应变的价值。结果 3组LVEDD、LVESD、LVEDV、LVESV、LVEF、PAD及PAP差异均有统计学意义(P均<0.05);组间两两比较,LVEDD、LVESD、LVEDV、LVESV及PAD差异均有统计学意义(P均<0.05),PDA组及对照组LVEF均高于ASD组(P均<0.05),PDA组PAP高于ASD组和对照组(P均<0.05)。3组左心室GLS、GCS、GRS及GAS差异均有统计学意义(P均<0.05),两两比较,组间GCS、GRS及GAS差异均有统计学意义(P均<0.05);PDA组GLS高于ASD及对照组(P均<0.05)。PDA组左心室GAS与PAD、LVEDD、LVESD、LVEDV、LVESV、动脉导管内径及长度均呈线性相关(P均<0.01),其中PAD、LVEDV及LVESV为主要影响因素(P均<0.05);ASD组左心室GAS与缺损处宽度、LVEDD、LVEDV、LVESV及LVEF均呈线性相关(P均<0.05),其中缺损处宽度为主要影响因素(P<0.01)。结论 3D-STE可定量评价容量负荷改变后左心室三维整体应变,其面积应变与容量负荷呈线性相关,即左心室心肌纤维随容量负荷改变而发生重塑。
英文摘要:
      Objective To observe overall strain of left ventricular under changed volume load by three-dimension speckle tracking echocardiography (3D-STE), quantitatively. Methods A total of 35 patients with simple patent ductus arteriosus (PDA, PDA group), 35 with secondary atrial septal defect (ASD, ASD group) and 35 healthy physical examinee (control group) were enrolled, and routine ultrasound and 3D-STE data were analyzed. Left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricle posterior wall thickness at end-diastole (LVPWT), interventricular septum thickness (IVST), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), pulmonary artery diameter (PAD), pulmonary arterial systolic pressure (PAP), global longitudinal/circumferential/radial/area strain (GLS/GCS/GRS/GAS) were compared. The impact factors of left ventricular GAS of PDA or ASD patients were observed. The value of 3D-STE for evaluating the three-dimensional overall strain of left ventricular under changed volume load was explored. Results There were significant differences of LVEDD, LVESD, LVEDV, LVESV, LVEF, PAD and PAP among 3 groups (all P<0.05), as well as LVEDD, LVESD, LVEDV, LVESV and PAD between each 2 groups (all P<0.05). LVEF of PDA group and control group were higher than that of ASD group (both P<0.05), and PAP of PDA group was higher than that of ASD group and control group (both P<0.05). There were significant differences of left ventricular GLS, GCS, GRS and GAS among 3 groups (all P<0.05), as well as GCS, GRS and GAS between each 2 groups (all P<0.05), while GLS of PDA group was higher than that of ASD group and control group (both P<0.05). In PDA group, left ventricular GAS was linearly correlated with PAD, LVEDD, LVESD, LVEDV, LVESV, diameter and length of ductus arteriosus (all P<0.01), and PAD, LVEDV and LVESV were the main influencing factors (all P<0.05); In ASD group, left ventricular GAS was linearly correlated with defect width, LVEDD, LVEDV, LVESV and LVEF (all P<0.05), and width of ASD was the main influencing factor (P<0.01). Conclusion 3D-STE could quantitatively evaluate three-dimensional global strain of left ventricular under changed volume load. There was a linear correlation between left ventricular area strain and volume load, that as, left ventricular myocardial fiber remoulded with the change of volume load.
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