二维斑点追踪显像技术评价早期心尖肥厚型心肌病的心肌应变

发布时间：2018-02-15 22:09

本文关键词： 超声心动描记术斑点追踪成像心肌应变心肌病肥厚性　出处：《中国介入影像与治疗学》2015年09期 　论文类型：期刊论文

【摘要】：目的探讨二维斑点追踪显像评价早期心尖肥厚型心肌病(PAHCM)患者心肌应变价值。方法对26例PAHCM患者(PAHCM组)、高血压左心室肥厚患者(高血压组)及健康志愿者(正常对照组),行二维超声心动图检查,记录二尖瓣、乳头肌和心尖水平左心室短轴及心尖四腔、三腔、二腔心切面的二维超声图像。使用QLab 9.1软件测量左心室壁各个节段圆周应变峰值(CS)、纵向应变峰值(LS),计算各水平(二尖瓣水平、乳头肌水平及心尖水平)的平均CS、LS及整体CS(GCS)、整体LS(GLS)。最后筛选出具有诊断效力的指标,并绘制ROC曲线评价诊断效果。结果与高血压组比较,PAHCM组二尖瓣水平、乳头肌水平CS、LS及左心室GCS、GLS的绝对值增加,而心尖水平CS、LS的绝对值减低,差异均有统计学意义(P均0.05)。与正常对照组比较,PAHCM组乳头肌水平、心尖水平CS、LS及左心室GCS、GLS的绝对值减低,差异均有统计学意义(P均0.05),而二尖瓣水平CS、LS的绝对值之间差异无统计学意义(P0.05)。与正常对照组比较,高血压组各个水平CS、LS及GCS、GLS的绝对值减低,差异均有统计学意义(P均0.05)。结论二维斑点追踪显像技术可以准确定量测量PAHCM患者心肌应变,反映心肌变形能力的变化。联合应用心尖水平CS和心尖水平LS可较好地识别和鉴别PAHCM。
[Abstract]:Objective to evaluate the myocardial strain in patients with early apical hypertrophic cardiomyopathy (PAHCM) by two dimensional speckle tracing imaging. Methods 26 cases of PAHCM patients with PAHCM, hypertensive patients with left ventricular hypertrophy (LVH) and healthy volunteers (normal) were studied. In the control group, two-dimensional echocardiography was performed. Mitral valve, papillary muscle and apical level left ventricular short axis and apical four-chamber, three-chamber were recorded. Two-dimensional ultrasound image of two-chamber central section. The peak values of circumferential strain and longitudinal strain of left ventricular wall were measured by using QLab 9.1 software. The peak values of longitudinal strain were calculated at different levels (mitral valve level, mitral valve level, mitral valve level). The mean CSLS of papillary muscle level and apical level), the whole CSS-GCSS, the whole LSS-GLSs. Finally, the indexes with diagnostic efficacy were screened, and the ROC curve was drawn to evaluate the diagnostic effect. Results compared with the hypertension group, the mitral valve level in the PAHCM group was evaluated. Compared with the control group, the absolute values of papillary muscle and left ventricular GCSS-GLS were increased, while the apical CSLS were decreased (P < 0.05). Compared with the normal control group, the absolute values of papillary muscle, apical CSLS and left ventricular GCSLS were decreased in PAHCM group. The difference was statistically significant (P < 0.05), but there was no significant difference between the absolute values of mitral valve level CSLS (P 0.05). Compared with the normal control group, the absolute values of CSL and GCS GLS in the hypertension group were lower than those in the normal control group. Conclusion Two-dimensional speckle tracing imaging can accurately and quantitatively measure myocardial strain and reflect the changes of myocardial deformability in patients with PAHCM. Combined use of apical CS and apical LS can better identify and differentiate PAHCMs.Conclusion two dimensional speckle tracing imaging can accurately and quantitatively measure myocardial strain and reflect the changes of myocardial deformability in patients with PAHCM.
【作者单位】：中国医科大学附属盛京医院超声科;
【基金】：辽宁省科技厅科学技术计划项目(2013225049)
【分类号】：R542.2;R540.45

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