三维斑点追踪技术评价正常婴幼儿、儿童及青少年左心室心肌应变的研究

发布时间：2018-05-02 12:21

本文选题：三维斑点追踪技术 + 儿童　；参考：《郑州大学》2012年硕士论文

【摘要】：目的应用三维斑点追踪技术(three-dimensional speckle tracking,3D-STI)探讨正常婴幼儿、儿童及青少年心肌纵向应变、径向应变及圆周应变的特征,为临床应用三维斑点追踪技术评价儿童左室收缩功能提供参考数据。对象与方法选取126例3天～15岁健康受试者,按年龄分为5组,A婴幼儿组(3天～3岁),B学龄前期组(3～6岁),C学龄期组(6～10岁),D青春前期组(10～13岁),E青春期组(13～15岁)。经胸超声同时采集左心室心尖四腔切面和心尖两腔切面图像后,获取左心室三维全容积动态图像,存储图像后运用3D-STI分析软件进行在线分析。分析获取左心室心肌收缩期16节段纵向峰值应变(peak longitudinal srain,PLS)、径向峰值应变(peak radial strain,PRS)、圆周峰值应变(peak circumferential strain,PCS)及左室整体纵向峰值应变(peak global longitudinal srain,PGLS)、左室整体径向峰值应变peak global radial strain,PGRS)及左室整体圆周峰值应变(peak global circumferential strain,PGCS)。观察16节段PLS、PRS及PCS特征并比较不同年龄组间PGLS、PGRS及PGCS的差异。结果 1各组内比较 ①PLS测值心尖段中间段基底段,各组内部分室壁心尖段与基底段和中间段比较差异有统计学意义(P0.05)； ②各组内部分室壁基底段、中间段、心尖段PRS测值比较差异有统计学意义(P0.05),同一室壁内PRS测值中间段心尖段； ③各组内部分室壁基底段、中间段、心尖段PCS测值比较差异有统计学意义(P0.05)。 2各组间比较 ①PGLS随年龄增长大致呈递减趋势,五组间差异有统计学意义(P0.05)；其中A组、B组及C组PGLS测值大于D组及E组,差异有统计学意义(P0.05)； ②PGRS测值各组间分布比较均一,组间差异无统计学差异(P0.05)； ③PGCS测值随年龄增长大致呈递增趋势,五组间差异有统计学意义(P0.05)；其中A组PGLS测值小于D组及E组,差异有统计学意义(P0.05)。结论 1.正常儿童左心室16节段心肌纵向、径向及圆周应变具有自身特征,存在节段性差异,这种局部心肌应变分布的不均一可能与心肌纤维排列及不同时期儿童心脏的生理解剖特点有关。 2.不同年龄组正常儿童左室心肌功能分布存在不均一性,主要体现在婴幼儿组与青春期组之间的差异。左心室整体峰值应变随年龄增长具有一定的规律：纵向峰值应变随年龄增长递减,圆周峰值应变随年龄增长递增,径向峰值应变随年龄增长无明显变化。
[Abstract]:Purpose Three-dimensional speckle tracking3D-STI technique was used to study the characteristics of longitudinal, radial and circumferential strain of myocardium in normal infants, children and adolescents, and to provide reference data for clinical evaluation of left ventricular systolic function by using three-dimensional speckle tracing technique. Objects and methods 126 healthy subjects aged from 3 days to 15 years old were divided into 5 groups according to their ages: 3 days old and 3 years old, 6 years old, 10 years old, prepuberty group, 13 years old, and E group, 13 years old and 15 years old, respectively. The left ventricular three-dimensional full-volume dynamic images were obtained by transthoracic ultrasound after the images of the four-chamber and two-chamber sections of the left ventricular apex were collected simultaneously. The images were stored and analyzed online by 3D-STI software. The longitudinal peak strain of 16 segments of left ventricular myocardium during systolic period, peak longitudinal straining, radial peak strain, peak radial straining, peak circumferential straining, and left ventricular whole longitudinal peak strain peak global longitudinal srainp PGLSs, left ventricular global radial peak strain peak global radial were obtained. The peak strain peak global circumferential strainn (PGCSS) and the peak circumferential strain of the left ventricle (PGCSs) were also found in the left ventricle. To observe the characteristics of PLSS-PRS and PCS in 16 segments and to compare the difference of PGRS and PGCS among different age groups. Result 1Intra-group comparison There were significant differences between the apical segment and the basal segment and the middle segment in the apical segment of the ventricular wall in each group (P 0.05), and there was a significant difference between the apical segment of the ventricular wall and the basal segment and the middle segment in each group. 2There were significant differences in PRS between the basal segment, middle segment and apical segment of the ventricular wall in each group (P 0.05), and the apical segment of the middle segment was measured by PRS in the same ventricular wall. 3There were significant differences in PCS between the basal segment, middle segment and apical segment of ventricular wall in each group (P 0.05). 2 comparison between groups The 1PGLS of group A and group C was significantly higher than that of group D and E, and the difference was statistically significant among the five groups (P 0.05), and the values of PGLS in group A and group C were higher than those in group D and group E. The distribution of 2PGRS was uniform among the groups, and there was no statistical difference among the groups (P 0.05). The 3PGCS values showed an increasing trend with the increase of age, and the differences among the five groups were statistically significant (P 0.05), and the PGLS values in group A were lower than those in group D and group E (P 0.05). Conclusion 1. The longitudinal, radial and circumferential strains of 16 segments of left ventricle in normal children have their own characteristics, and there are segmental differences. The heterogeneity of the local myocardial strain distribution may be related to the arrangement of myocardial fibers and the physiological and anatomical characteristics of children's heart at different stages. 2. The distribution of left ventricular myocardial function in normal children of different age groups was uneven, mainly reflected in the difference between infant and adolescent groups. The global peak strain of left ventricle has a certain regularity with age: longitudinal peak strain decreases with age, circumferential peak strain increases with age, radial peak strain does not change with age.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.4

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