陈莹,刘昕,王建华.实时三维斑点追踪成像技术评价无节段性室壁运动异常的不同程度冠状动脉病变患者的心肌应变[J].中国医学影像技术,2014,30(10):1495~1499
实时三维斑点追踪成像技术评价无节段性室壁运动异常的不同程度冠状动脉病变患者的心肌应变
Real-time three-dimentional speckle tracking imaging on assessment of myocardial strain in different degrees of coronary artery disease patients without regional wall motion abnormality
投稿时间:2014-04-21  修订日期:2014-07-24
DOI:
中文关键词:  超声检查  冠状动脉疾病  心肌应变  节段性室壁运动异常
英文关键词:Ultrasonography  Coronary disease  Myocardial strain  Regional wall motion abnormality
基金项目:河北省2013医学科学研究重点课题计划指令性课题项目(20130019)。
作者单位E-mail
陈莹 承德医学院影像医学与核医学系, 河北 承德 067000  
刘昕 保定市第一中心医院超声科, 河北 保定 071000 lxlx001@126.com 
王建华 中国人民解放军北京军区总医院超声科, 北京 100700  
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中文摘要:
      目的 探讨实时三维斑点追踪成像(RT3D-STI)技术评价不同程度冠状动脉病变患者左心室心肌应变的价值。方法 收集超声结果提示无节段性室壁运动异常(RWMA)的冠心病患者109例,并根据冠状动脉造影(CAG)结果分为:对照组(n=30)、单支病变组(n=34)、多支病变组(n=45)。应用RT3D-STI技术获得左心室整体纵向应变(GLS)、整体周向应变(GCS)、整体面积应变(GAS)、整体径向应变(GRS)及左心室射血分数(LVEF)等,比较各参数的组间差异,并分析不同应变参数间及其与LVEF的相关性。结果 随着冠状动脉病变程度的加重,GLS、GCS、GAS、GRS逐渐减低,单支病变组低于对照组(P均<0.05),多支病变组低于单支病变组(P均<0.05),GAS组间差异较显著。GLS、GCS、GAS与GRS相关系数分别为-0.874、-0.848、-0.906,GAS与GRS相关关系更为密切;GLS、GCS、GAS、GRS与LVEF的相关系数分别为-0.684、-0.657、-0.717、0.672,GAS与LVEF相关性最好。结论 RT3D-STI技术参数能够定量评价无节段性室壁运动异常的不同程度冠状动脉病变患者心肌应变,测量准确性及可重复性高,新参数GAS更具优势。
英文摘要:
      Objective To explore the value of real-time three-dimentional speckle tracking imaging (RT3D-STI) on assessment of myocardial strain in patients with different degrees of coronary artery disease (CAD). Methods Totally 109 CAD patients without regional wall motion abnormality (RWMA) were divided into control group (n=30), single vessel disease group (n=34) and multi-vessel disease group (n=45) based on coronary angiography (CAG). All the patients underwent three-dimentiondal echocardiography, left ventricular globle longitudinal strain (GLS), globle circumferential strain (GCS), globle area strain (GAS), globle radial strain (GRS) and left ventricular ejection fraction (LVEF),etc,were aquired by RT3D-STI respectively. Difference of each parameter among three groups were compared, the correlation among different strain parameters and LVEF were analyzed. Results GLS, GCS, GAS, GRS decreased with the degree of the coronary artery disease, and GLS, GCS, GAS, GRS in single vessel disease group were lower than those in control group(all P<0.05), and GLS, GCS, GAS, GRS in multi-vessel disease group were lower than in single vessel disease group(all P<0.05). GAS showed significant difference among the three group. Correlation coefficents of GLS, GCS, GAS with GRS were -0.874, -0.848, -0.906, GAS was closely related to GRS; the correlation coefficents between different strain parameters and LVEF were -0.684, -0.657,-0.717, 0.672, GAS had the best correlation with GRS. Conclusion RT3D-STI strain parameters can quantitatively assess the myocardial strain in different degrees of CAD patients without RWMA, showing high measurement accuracy and reproducibility. The novel GAS plays an more important role.
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