| 付倩,谢明星,王新房,吕清,方凌云,王静,袁莉,程龙,项飞翔.超声二维斑点追踪成像技术评价大鼠急性心肌梗死后局部心肌存活性[J].中国医学影像技术,2010,26(4):623~626 |
| 超声二维斑点追踪成像技术评价大鼠急性心肌梗死后局部心肌存活性 |
| Evaluation of regional myocardial viability in rats after acute myocardial infarction with two-dimensional speckle tracking imaging |
| 投稿时间：2009-10-19 修订日期：2009-12-21 |
| DOI： |
| 中文关键词: 超声心动描记术 心室功能,左 心肌梗死 二维应变 |
| 英文关键词:Echocardiography Ventricular function, left Myocardial infarction Two-dimensional strain |
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| 中文摘要: |
| 目的 探讨超声二维斑点追踪成像技术评价大鼠急性心肌梗死后局部心肌存活性的应用价值。方法 20只Wistar大鼠随机分为急性心肌梗死组和假手术组,每组10只。于基础状态和恢复灌注24 h后对各组大鼠行超声心动图检查,记录左心室乳头肌短轴高帧频二维图像,测量节段心肌的收缩期峰值径向应变(PRS)、环向应变(PCS),并采用解剖M型超声测量左心室舒张末期内径(LVIDd)、左心室收缩末期内径(LVIDs)、短轴缩短率(FS)、射血分数(EF)和室壁增厚率(TR)。实验结束后取大鼠心脏行左心室乳头肌短轴TTC染色并计算节段心肌的梗死面积(AN)。以TTC染色作为金标准,ROC曲线分析上述二维应变及TR参数评价梗死节段的准确性。结果 ①与心肌梗死组基础状态及假手术组术后相比,心肌梗死组术后的LVIDd和LVIDs值均明显增加,FS、EF和前间隔TR值均明显降低(P<0.05);②与心肌梗死组基础状态及假手术组术后相比,心肌梗死组术后的前间隔、前壁、前侧壁、后侧壁和后间隔的PRS及PCS值均明显减低,心肌梗死组术后前间隔、前壁和前侧壁的PRS及PCS值明显低于其他节段(P<0.05);③以TTC染色所得节段心肌AN>50%为梗死节段,ROC曲线分析显示PCS为判断梗死心肌的最佳指标,PCS值为临界值(－6.14%)时诊断梗死心肌的敏感度为93.75%,特异度为90.91%。结论 超声二维斑点追踪成像技术能准确量化局部心肌功能。 |
| 英文摘要: |
| Objective To observe the value of two-dimensional speckle tracking imaging (2D-STI) in assessing regional myocardial viability of rats after acute myocardial infarction. Methods Twenty Wistar rats were randomly divided into acute myocardial infarction group and sham-operation group (each n=10). Echocardiography was performed at baseline and 24 h after reperfusion. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the papillary muscle level. Peak radial strain (PRS) and peak circumferential strain (PCS) of each segment were measured at systolic period. Left ventricular internal diameter at diastole (LVIDd) and systole (LVIDs), fractional shortening (FS), ejection fraction (EF), wall thickening rate (TR) were measured with anatomical M-model echocardiography. Area of necrosis (AN) of each segment was measured after triphenyl tetrazolium chloride (TTC) staining. Based on TTC staining, ROC curve was used to analyze the accuracy of two-dimensional strain and TR index in identifying infarcted segment. Results ①Compared with acute myocardial infarction group at baseline and sham-operation group after operation, LVIDd and LVIDs of acute myocardial infarction group after operation increased significantly respectively (P<0.05), FS, EF and anteroseptal wall TR reduced significantly (P<0.05). ②Compared with acute myocardial infarction group at baseline and sham-operation group after operation, PRS and PCS decreased significantly in anteroseptal, anterior, anterolateral, inferolateral and inferoseptal segments of myocardial infarction group after operation (P<0.05), especially in anterosepetal, anterior and anterolateral segments (P<0.05). ③ROC analysis showed PCS had the best ability to identify infarcted myocardium as defined by AN>50%. Using a cut-off of －6.14%, PCS had a sensitivity of 93.75% and specificity of 90.91% for distinguishing infarcted from viable myocardium. Conclusion 2D-STI can accurately quantify regional myocardial function, providing a sensitive and noninvasive means to assess regional myocardial viability. |
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