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王金锐,杨颖,杨敬英,王淑敏,王建华,李汇文.定量组织速度成像对心梗病人左室心肌局域舒张功能的分析[J].中国医学影像技术,2001,17(1):44~46

定量组织速度成像对心梗病人左室心肌局域舒张功能的分析

Evaluation of Regional Diastolic Function in Patients with Myocardial Infarction Using Quantitative Tissue Velocity Imaging

投稿时间：2000-10-07

DOI：

中文关键词: 定量组织速度成像心肌梗死舒张功能,左心室

英文关键词:Quantitative tissue velocity imaging(QTVI) Myocardial infarction Diastolic function, left ventricle

基金项目:

作者	单位
王金锐	内蒙古超声影像研究所,内蒙古东胜 017000
杨颖	内蒙古医学院病理生理教研室
杨敬英	内蒙古超声影像研究所,内蒙古东胜 017000
王淑敏	内蒙古超声影像研究所,内蒙古东胜 017000
王建华	内蒙古超声影像研究所,内蒙古东胜 017000
李汇文	内蒙古超声影像研究所,内蒙古东胜 017000

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中文摘要:

目的探索冠心病人左室等容舒张期和快速充盈期局部心肌的舒张运动特点及其临床意义。方法以60帧/秒以上的高帧频对18例心肌梗死病人(MI组)和20例正常人(对照组)的左室心肌进行QTVI检查。获取左室各节段心肌长轴方向的同步运动曲线,测量其等容舒张期、快速充盈期、心房收缩期局部心肌的运动速度V_I_R、V_E、V_A,并测量二尖瓣口血流的快速充盈速度(E)和左房收缩充盈速度(A)及A/E比值。结果对照组17/20(85％)例、344/360(95.6％)节段V_IR≤2.0cm/s,平均 -0.26±1.13cm/s;MI组2/18(11.1％)例、247/324(76.2％)节段V_IR ≤2.0cm/s,平均0.04±1.46cm/s。两组间V_IR ＞2.0cm/s例数的差别(P＜0.001)和V_IR 值的差别(P＜0.005)都具有非常显著性的意义。局部节段心肌V_IR极小加毗邻节段心肌V_IR ＞2.0cm/s ,对诊断局部舒张功能异常的敏感性88.9％,特异性85％,准确性86.8％,阳性预测值84.2％。 A/E＞1者,MI组11/18(61.1％)例,多于对照组7/20(35％)例, P＜0.05;但A/E 与V_IR无相关性。结论 QTVI能敏感、直观地无创定量评价局部心肌等容舒张功能异常,对诊断冠心病心肌等容缺血可能有重要价值。

英文摘要:

Objective This study was undertaken to detect the regional diastolic wall motion features during isovolumic relaxation and early diastole in patients with coronary artery disease, and their clinical significance. Methods 18 patients with myocardial infarction(MI) and 20 normal subjects(Nor) underwent quantitative tissue velocity imaging (QTVI) with frame rates of over 60 per second. Off-line left ventricular regional velocity profiles along long axis were obtained synchronously, and peak tissue velocities of LV segments during isovolumic relaxation (V_IR), early diastole (V_E) and atrial contraction (V_A) were measured. Mitral valve peak flow velocities during early diastole (E) and atrial contraction (A) were also measured and A/E ratio was calculated. Results V_IR ＜2.0cm/s in 17 of 20 normal subjects (85％), 344 of 360 (95.6％) myocardial segments, and the average value is -0.26±1.13cm/s; V_IR ＞2.0cm/s only in 3 of 20 subjects (15％), 16 of 360 (4.4％) segments. Whereas V_IR＞2cm/s in 16 of 18 (88.9％) MI patients, 77 of 324 (23.8％) segments; V_IR ＜2cm/s in 2 of 18 (11.1％) patients, 247 of 342 (76.2％) segments, with average of 0.04±1.46cm/s. The differences of V_IR ＞2.0cm/s numbers (P＜0.001) and V_IR values (P＜0.005) between the two groups are significant. Regional minor V_IR combining neighbor segments V_IR＞2.0cm/s are helpful in diagnosing regional diastolic wall motion abnormalities, with sensitivity, specificity, accuracy rate and positive predictive value of 88.9％, 85％, 86.8％ and 84.2％, respectively. A/E＞1 appears in more MI patients (11 of 18, 61.1％) than normal subjects (7 of 20, 35％; P＜0.05), but V_IR and A/E have no correlation. The sensitivity and specificity of A/E＞1 in LV diastolic abnormality assessment are 61.1％ and 63.2, respectively. Conclusion Regional myocardial ischeamia and infarction can course significant regional diastolic wall motion abnormalities along long axis, and QTVI can evaluate the abnormalities quantitatively and synchronously with high sensitivity, and have the potential value in regional myocardial ischeamia diagnosis.

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