二维斑点追踪显像评价左室旋转和扭转运动在早期心尖肥厚型心肌病诊断中的价值

发布时间：2018-07-12 16:59

  本文选题：超声心动图 + 斑点追踪技术　； 参考：《中国医科大学学报》2015年08期

【摘要】：目的探讨二维斑点追踪显像评价左室旋转和扭转运动在早期心尖肥厚型心肌病(PAHCM)患者诊断过程中的准确性。方法选择26例PAHCM患者、26例高血压左心室肥厚(HLVH)患者和26例健康志愿者,分别行二维超声心动图检查,记录二尖瓣和心尖水平左室短轴及心尖四腔、二腔心切面的二维超声图像。使用QLAB 9.1软件测量各短轴平面内膜下心肌旋转(endo-rot)、外膜下心肌旋转(epi-rot)、跨壁扭转(mural-tor)及平面旋转(bulk-rot),计算出整体扭转角度(G-tor)。筛选出诊断效力的指标,并绘制受试者工作特征(ROC)曲线来评价诊断的效果。结果在二尖瓣水平,PAHCM组与正常对照组相比,endo-rot、epi-rot、mural-tor及bulk-rot指标的差异无统计学意义(P0.05);PAHCM组与HLVH组相比,这些指标的差异有统计学意义(P0.05)。HLVH组与正常对照组相比,endo-rot、epi-rot、mural-tor及bulk-rot指标的差异有统计学意义(P0.05)。在心尖水平,3组间epi-rot的差异无统计学意义(P0.05)。PAHCM组与正常对照组相比,endo-rot、mural-tor及bulk-rot指标的差异有统计学意义(P0.05);PAHCM组与HLVH组相比,这些指标的差异有统计学意义(P0.05)。与正常对照组相比,HLVH组在endo-rot、mural-tor及bulk-rot指标上的差异有统计学意义(P0.05)。各组间G-tor的差异均有统计学意义(P0.05)。ROC曲线分析显示,G-tor鉴别诊断PAHCM的准确性高(ROC曲线下的面积为0.89),敏感度为73.08%,特异度为92.31%。结论二维斑点追踪显像技术可以准确定量测量PAHCM患者左室心肌旋转和扭转的变化。使用G-tor可精确地识别和鉴别高血压心肌肥厚和PAHCM。
[Abstract]:Objective to evaluate the diagnostic accuracy of left ventricular rotation and torsion motion in patients with early apical hypertrophic cardiomyopathy (PAHCM). Methods Twenty-six patients with hypertension and 26 patients with left ventricular hypertrophy (HLVH) and 26 healthy volunteers were examined by two dimensional echocardiography. Myocardial rotation (endo-rot), submembranous myocardial rotation (epi-rot), transmural torsion (mural-tor) and planar rotation (bulk-rot) were measured by QLAB9.1 software, and the global torsion angle (G-tor) was calculated. The diagnostic efficacy index was screened and the operating characteristics (ROC) curve was drawn to evaluate the diagnostic effect. Results there was no significant difference in the parameters of bulk-rot and bulk-rot between the PAHCM group and the normal control group (P0.05), and there was no significant difference between the PAHCM group and the HLVH group. There were significant differences between HLVH group and normal control group (P0.05). There were significant differences between HLVH group and normal control group (P0.05). There was no significant difference in epi-rot between the three groups at the apical level (P0.05). There were significant differences in the indexes of bulk-rot and epi-rot between the PAHCM group and the normal control group (P0.05). There was significant difference in these indexes between the PAHCM group and the HLVH group (P0.05). Compared with the normal control group, the difference of endo-rotator mural-tor and bulk-rot in HLVH group was statistically significant (P0.05). The difference of G-tor among groups was statistically significant (P0.05) .ROC curve analysis showed that G-tor differential diagnosis of PAHCM was accurate (the area under ROC curve was 0.89), sensitivity was 73.08 and specificity was 92.31. Conclusion Two-dimensional speckle tracing imaging can accurately and quantitatively measure the changes of left ventricular rotation and torsion in patients with PAHCM. High blood pressure myocardial hypertrophy and PAHCM can be accurately identified and distinguished by G-tor.
【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】：R445.1;R542.2

【参考文献】

中国期刊全文数据库 前4条

1 Notomi Y.;Setser R.M.;Shiota T. ;J.D. Thomas;苏畅;;多普勒组织成像技术评价左心室扭转重构:标记磁共振成像验证研究[J];世界核心医学期刊文摘(心脏病学分册);2005年09期

2 张晶;毕文静;任卫东;肖杨杰;郭亚军;;二维斑点追踪成像对心肌淀粉样变患者左心室旋转和扭转运动的初步研究[J];生物医学工程与临床;2013年04期

3 肖杨杰;任卫东;王晓冰;陈昕;马春燕;李楠;刘爽;;超声二维斑点追踪技术评价心尖肥厚型心肌病左心室扭转运动[J];中国医学影像技术;2010年03期

4 宋光;张晶;任卫东;乔伟;詹莹;;早期心尖肥厚型心肌病的超声诊断价值[J];中国超声医学杂志;2015年05期

中国硕士学位论文全文数据库 前1条

1 周金玲;速度向量成像技术评价心尖肥厚型心肌病的左室扭转功能[D];河北医科大学;2011年

【共引文献】

中国期刊全文数据库 前10条

1 周玮s，

本文编号：2117830