陈晓菲,姜志荣,孙品,何香芹,王小凡,吕启凤,宋晓霞,田雨.3D-STI技术联合SYNTAX评分在评价复杂冠心病中的价值[J].中国医学影像技术,2020,36(4): |
3D-STI技术联合SYNTAX评分在评价复杂冠心病中的价值 |
Usefulness of 3D-STI Combined With SYNTAX Score in Evaluting Complex Coronary Artery Disease |
投稿时间:2019-07-27 修订日期:2020-04-13 |
DOI: |
中文关键词: 超声心动描记术 斑点追踪成像 SYNTAX评分 冠心病 |
英文关键词:Echocardiography Speckle tracking imaging SYNTAX score Coronary Disease |
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中文摘要: |
[摘要]目的 探讨实时三维斑点追踪(RT3D-STI)技术联合冠状动脉SYNTAX评分(SS)在评价复杂冠心病患者左室心肌功能中的价值。方法 78例复杂冠心病患者根据SS收集我院拟行冠状动脉造影术(CAG)患者141例,根据CAG影结果分为复杂冠心病组(三支主要冠状动脉和/或左主干狭窄>50%,n=78),非复杂冠心病组(单支/双支主要冠状动脉狭窄>50%,n=30)和对照组(冠状动脉狭窄≤50%,n=33),根据SS将复杂冠心病组分为低分亚组(SS<23,n=26),中分亚组(23≤SS<33,n=25)及高分亚组(SS≥33,n=27)。,应用3D-STI技术获取左心室整体纵向、径向、圆周、三维应变(GLS、GRS、GCS、G3DS)及各节段纵向、径向、圆周、三维应变(LS、RS、CS、3DS),计算平均基底段LS、RS、CS、3DS,中间段LS、RS、CS、3DS,心尖段LS、RS、CS、3DS,行组间比较分析获取相应测值,比较各组间的差异。结果 ①三组间整体、平均节段应变呈减小趋势(P<0.05)。2.三亚组的GLS、GRS、GCS、G3DS呈减小趋势(P<0.05),基底段LS、3DS,中间段LS、RS、CS、3DS,心尖段LS、RS、CS、3DS呈减小趋势LS-BAS、3DS-BAS、LS-MID、RS-MID、CS-MID、3DS-MID、LS-AP、RS-AP、CS-AP、(P<0.05)。②ROC曲线分析示GLS、GCS、GRS、G3DS对不同程度复杂冠心病有一定检测价值,以G3DS及GLS曲线下面积最大。③相关性分析示复杂冠心病组GLS、GCS、GRS、G3DS与冠状动脉SS呈负相关(r=-0.548,-0.366,-0.411,-0.556,P均<0.05)。④重复性检验:3D-STI参数在观察者内及观3DS-AP呈减小趋势(P<0.05)。3.ROC曲线分析:GLS、GCS、GRS、G3DS对不同程度复杂冠心病有一定检测价值,以G3DS及GLS曲线下面积最大。 4.相关性分析:复杂冠心病组GLS、GCS、GRS、G3DS与冠状动脉SS呈负相关(r=-0.548,-0.366,-0.411,-0.556,P均<0.05)。.察者间测量有良好的一致性。结论 RT3D-STI技术可在一定程度上反应复杂冠心病患者的冠状动脉病变程度,联合SYNTAX评分在复杂冠心病的诊断和指导治疗上有一定的积极意义。 |
英文摘要: |
[Abstract] Objective To discuss the value of the Real-time three-dimensional speckle tracking imaging(RT3D-STI) combined with the coronary artery SYNTAX scores(SS) in evaluating the left ventricular function of patients with complex coronary artery disease(CAD). Methods 78 patients with complex CAD wereA total of 141 patients, scheduled for coronary angiography(CAG), were enrolled in this study. According to the results of the CAG, the patients were divided into the control group(coronary artery stenosis rate≤50%, n=33), the non-complex CAD group(1/2-vessel stenosis rate>50% , n=30) and the complex CAD group(3-vessel and/or LM stenosis rate>50%, n=78). Based on the SS, the complex CAD group was further divided into the low score subgroup(SS<23, n=26), the medium score subgroup(23≤SS<33, n=25) and the high score subgroup(SS≥33, n=27) according to the SS. The global longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS), global three-dimensional strain(G3DS) and the longitudinal strain, radial strain, circumferential strain and three-dimensional strain of segments(LS, RS, CS, 3DS) were obtained by 3D-STI. Then the,and LS, RS, CS, 3DS of basal segment, middle segment and apical segment were further calculated. The differences among the groups were compared and analyzed. Results ①The global strains and the LS, 3DS of basal segment, the LS, RS, CS, 3DS of middle segment and the LS, RS, CS, 3DS of apical segment decreased gradually among the low score, the medium score and the high score subgroups (P<0.05). ②The receiver operating characteristic curve showed that the GLS、, GRS、, GCS、, G3DS had a certain value in detecting degrees of complex CAD, and the GLS and G3DS had the larger area under the curve.③The GLS, GRS, GCS and G3DS were negatively correlated with SS in the group of complex CAD(r=-0.548, -0.366, -0.411,, -0.556, P<0.05). ④The repeatability test showed that the 3D-STI had good interobserver and intraobserver consistency. Conclusion RT3D-STI can reflect the complexity of coronary artery lesions, and it has a certain guiding significance combined with SYNTAX score in the diagnosis and treatment of complex CAD. |
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