四维超声心动图对左心室收缩功能的研究
发布时间：2018-07-26 07:50
【摘要】：目的： 应用四维超声心动图中的左室四维自动定量分析技术（4-DimensionalAuto Left Ventricular quantification,4DAuto LVQ）评价心肌梗死患者收缩功能的变化，并联合应用四维应变（4D Strain）技术对心肌梗死患者的梗死部位、范围进行定位、定量分析。旨在探讨左室四维定量分析技术评价收缩功能的可行性和应用价值及四维应变技术对心肌梗死患者缺血心肌或梗死部位及范围进行定位、定量分析。 方法： 选择30例心肌梗死患者和20例健康志愿者，应用4V全容积心脏探头，启动三平面成像软件，连续采集3个心动周期的实时动态图像，即可获得心尖四腔、心尖两腔及心尖左室长轴切面，调整图像角度以获得最佳切面，点击ejection fraction，，图像自动停留在舒张末期帧，依次勾画三个图像的心内膜面，完成后自动跳转为收缩末期帧，重复上面的步骤，软件自动得出左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）、左室射血分数（LVEF）、心率（HR）、每搏输出量（SV）。在4D模式下，经胸连续采集4-6个心动周期的全容积心尖四腔切面图像，保证图像帧频大于心率的40%，如图像不满意可手动调节，得到最佳图像后，选择Volume，启动4D Auto LVQ软件，分别在舒张末期和收缩末期心内膜处放置两个点，一个放置在左心室二尖瓣环连线的中点，一个放置在心尖部心内膜面的顶点位置，软件自动获取左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）、左室射血分数（LVEF）、心率（HR）、每搏输出量（SV），并在左室四维定量分析技术的基础上启动四维应变技术，获得左心室17个节段的收缩末期峰值纵向应变（longitudinal strain，LS）。并用彩色编码的牛眼图将所有节段的应变值表达出来。所有采集的数据应用SPSS19.0软件进行分析。 结果： 1心肌梗死组与对照组HR、年龄差异均无显著性意义（P0.05）；应用4D Auto LVQ软件进行分析，与对照组相比，心肌梗死组每搏输出量（SV）、左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）明显增大，左心室射血分数（LVEF）明显减少，差异均有统计学意义（P0.05）；应用RT-3PE软件进行分析，与对照组相比，心肌梗死组每搏输出量（SV）、左室舒张末期容积（LVEDV）、左室收缩末期容积（LVESV）明显增大，左心室射血分数（LVEF）明显减少，差异均有统计学意义（P0.05）。 2应用RT-3PE和4D Auto LVQ两方法测量的正常对照组中HR、SV、LVEDV、LVESV、LVEF等各项参数均无明显差异（P0.05），应用两方法测量的心肌梗死组中HR、SV、LVEDV、LVESV、LVEF等各项参数均无明显差异（P0.05）。 3应用4D Auto LVQ技术测量的心肌梗死组LVEF和LVEDV，发现LVEF的减小与LVEDV的增大呈负相关（r=-0.720）。 4应用四维应变技术得出左心室17个节段基底段、中间段、心尖段及心尖帽纵向应变，心肌梗死组应变值均小于正常对照组，差异均具有统计学意义（P0.05）。 5四维纵向应变在正常对照组中左心室不同水平应变测值可发现如下规律：左心室收缩期峰值纵向应变在中间段呈最大趋势，基底段最小，心尖段居中。 结论： 14D Auto LVQ技术可以准确的对左室收缩功能各项参数进行测量，并且可以有效的对节段性室壁运动异常或已发生心肌形变的左心室收缩功能做出准确评价。 2联合应用四维应变技术可以准确的对左室心肌梗死或心肌缺血部位、范围进行定位、定量分析。
[Abstract]:Objective:
4-DimensionalAuto Left Ventricular quantification (4DAuto LVQ) was used to evaluate the changes of systolic function in patients with myocardial infarction with four dimensional echocardiography, and the location and quantitative analysis of the infarct sites in patients with myocardial infarction were combined with the four dimensional strain (4D Strain) technique. The feasibility and application value of the left ventricular four dimensional quantitative analysis technique to evaluate the systolic function and the four dimensional strain technique were used to locate the ischemic myocardium or infarct location and range of the patients with myocardial infarction.
Method:
In 30 patients with myocardial infarction and 20 healthy volunteers, the 4V full volume heart probe was used and the three plane imaging software was started. The real-time dynamic images of 3 cardiac cycles were collected continuously. The four cavity of the apex, the two cavities of the apex and the long axis of the left ventricle of the apex were obtained. The image angle was adjusted to obtain the best cut surface, and ejection fraction was clicked on the image self. At the end of diastolic frame, the intimal surface of the three images was sequentially outlined, and the end systolic frame was automatically jumps after completion, and the above steps were repeated. The software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV). Under 4D mode, continuous recovery was taken under the chest. A full volume apical four cavity slice image of 4-6 cardiac cycles is set up to ensure that the frame frequency of the image is greater than 40% of the heart rate. If the image is unsatisfactory, the image can be manually adjusted. After the best image is obtained, Volume is selected and the 4D Auto LVQ software is started, and two points are placed at the end diastolic and end-stage end-end endocardium, and one is placed on the left ventricular mitral annulus line. Midpoint, a location placed at the apex of the apical endocardium, the software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV), and the four dimensional strain technique was started on the basis of the left ventricular quantitative analysis technique to obtain 17 segments of the left ventricle. The peak longitudinal strain at the end of contraction (longitudinal strain, LS). The strain values of all segments were expressed with the color coded eye diagram. All the data collected were analyzed by SPSS19.0 software.
Result:
The age difference between the 1 myocardial infarction group and the control group was no significant difference (P0.05), and the 4D Auto LVQ software was used to analyze the stroke volume (SV), the left ventricular end diastolic volume (LVEDV), the left ventricular end systolic volume (LVESV) and the left ventricular ejection fraction (LVEF) in the myocardial infarction group compared with the control group, and the difference was statistically significant. Learning significance (P0.05); compared with the control group, compared with the control group, the stroke volume (SV), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) decreased significantly in the myocardial infarction group, and the difference of left ventricular ejection fraction (LVEF) was significantly decreased (P0.05).
2 the parameters of HR, SV, LVEDV, LVESV, LVEF in the normal control group measured by RT-3PE and 4D Auto LVQ two were not significantly different (P0.05). There were no significant differences in the parameters in the myocardial infarction group measured with two methods.
3 LVEF and LVEDV in myocardial infarction group measured by 4D Auto LVQ technology showed that the decrease of LVEF was negatively correlated with the increase of LVEDV (r=-0.720).
4 the strain of the 17 segments of the left ventricle, the middle segment, the apical segment and the apical cap were obtained by the four dimensional strain technique. The strain values of the myocardial infarction group were all smaller than those of the normal control group, and the difference was statistically significant (P0.05).
The following rules were found in 5 four dimensional longitudinal strain in the left ventricle of the normal control group: the peak longitudinal strain of the left ventricular systole was the largest in the middle segment, the basal segment was the smallest, and the apical segment was middle.
Conclusion:
14D Auto LVQ technology can accurately measure the parameters of left ventricular systolic function, and can effectively evaluate the left ventricular systolic function of segmental wall movement or cardiac muscle deformation.
2 combined with four-dimensional strain technology can accurately locate and quantify the location and range of left ventricular myocardial infarction or myocardial ischemia.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R540.45;R54
本文编号：2145352
[Abstract]:Objective:
4-DimensionalAuto Left Ventricular quantification (4DAuto LVQ) was used to evaluate the changes of systolic function in patients with myocardial infarction with four dimensional echocardiography, and the location and quantitative analysis of the infarct sites in patients with myocardial infarction were combined with the four dimensional strain (4D Strain) technique. The feasibility and application value of the left ventricular four dimensional quantitative analysis technique to evaluate the systolic function and the four dimensional strain technique were used to locate the ischemic myocardium or infarct location and range of the patients with myocardial infarction.
Method:
In 30 patients with myocardial infarction and 20 healthy volunteers, the 4V full volume heart probe was used and the three plane imaging software was started. The real-time dynamic images of 3 cardiac cycles were collected continuously. The four cavity of the apex, the two cavities of the apex and the long axis of the left ventricle of the apex were obtained. The image angle was adjusted to obtain the best cut surface, and ejection fraction was clicked on the image self. At the end of diastolic frame, the intimal surface of the three images was sequentially outlined, and the end systolic frame was automatically jumps after completion, and the above steps were repeated. The software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV). Under 4D mode, continuous recovery was taken under the chest. A full volume apical four cavity slice image of 4-6 cardiac cycles is set up to ensure that the frame frequency of the image is greater than 40% of the heart rate. If the image is unsatisfactory, the image can be manually adjusted. After the best image is obtained, Volume is selected and the 4D Auto LVQ software is started, and two points are placed at the end diastolic and end-stage end-end endocardium, and one is placed on the left ventricular mitral annulus line. Midpoint, a location placed at the apex of the apical endocardium, the software automatically obtained the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), heart rate (HR), and per stroke output (SV), and the four dimensional strain technique was started on the basis of the left ventricular quantitative analysis technique to obtain 17 segments of the left ventricle. The peak longitudinal strain at the end of contraction (longitudinal strain, LS). The strain values of all segments were expressed with the color coded eye diagram. All the data collected were analyzed by SPSS19.0 software.
Result:
The age difference between the 1 myocardial infarction group and the control group was no significant difference (P0.05), and the 4D Auto LVQ software was used to analyze the stroke volume (SV), the left ventricular end diastolic volume (LVEDV), the left ventricular end systolic volume (LVESV) and the left ventricular ejection fraction (LVEF) in the myocardial infarction group compared with the control group, and the difference was statistically significant. Learning significance (P0.05); compared with the control group, compared with the control group, the stroke volume (SV), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) decreased significantly in the myocardial infarction group, and the difference of left ventricular ejection fraction (LVEF) was significantly decreased (P0.05).
2 the parameters of HR, SV, LVEDV, LVESV, LVEF in the normal control group measured by RT-3PE and 4D Auto LVQ two were not significantly different (P0.05). There were no significant differences in the parameters in the myocardial infarction group measured with two methods.
3 LVEF and LVEDV in myocardial infarction group measured by 4D Auto LVQ technology showed that the decrease of LVEF was negatively correlated with the increase of LVEDV (r=-0.720).
4 the strain of the 17 segments of the left ventricle, the middle segment, the apical segment and the apical cap were obtained by the four dimensional strain technique. The strain values of the myocardial infarction group were all smaller than those of the normal control group, and the difference was statistically significant (P0.05).
The following rules were found in 5 four dimensional longitudinal strain in the left ventricle of the normal control group: the peak longitudinal strain of the left ventricular systole was the largest in the middle segment, the basal segment was the smallest, and the apical segment was middle.
Conclusion:
14D Auto LVQ technology can accurately measure the parameters of left ventricular systolic function, and can effectively evaluate the left ventricular systolic function of segmental wall movement or cardiac muscle deformation.
2 combined with four-dimensional strain technology can accurately locate and quantify the location and range of left ventricular myocardial infarction or myocardial ischemia.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R540.45;R54
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