比较三维和二维斑点追踪技术评价左室收缩功能
发布时间：2018-08-17 10:16
【摘要】：目的：比较三维斑点追踪技术(3DT)和二维斑点追踪技术(2DT)评价正常人左心室心肌纵向、圆周和径向应变,探讨3DT在评价左心室收缩功能的应用价值。 方法：我院健康体检者46例,经胸超声同时采集左心室心尖四腔和两腔切面图像后,获取左心室三维全容积动态图像,存储图像后启动3DT分析软件进行脱机分析,获取左心室纵向、圆周、径向应变和面积应变,左心室舒张末期容积、收缩末期容积及左心室射血分数,同时记录运用3DT进行存储图像和分析图像所用时间；经胸超声采集并存储左心室短轴二尖瓣水平、乳头肌水平和心尖水平二维图像和心尖四腔切面、两腔切面和左心室长轴切面二维图像,启动2DT分析软件脱机分析,获取左心室纵向、圆周和径向应变,同时记录运用2DT进行存储图像和分析图像所用时间,Simpson法测量左心室舒张末期容积、收缩末期容积及左心室射血分数。分析并比较上述两种方法。 结果：①运用3DT时存储图像和分析图像所用时间均明显短于2DT(P0.05)。 ②与2DT相比,应用3DT测得的EDV、LVEF较小,差异具有统计学意义(P均0.05),而ESV两者间差异无统计学意义(P0.05)。 ③3DT测得的左心室整体纵向收缩期峰值应变明显低于2DT(P0.05),整体圆周收缩期峰值应变明显高于2DT(P0.05),两种方法测得的整体径向收缩期峰值应变差异无统计学意义(P0.05)。 ④从二尖瓣水平至心尖水平,3DT与2DT测得的左心室心肌3个方向的应变变化规律一致,即：左室短轴径向收缩期峰值应变从心尖水平至乳头肌水平再至二尖瓣水平呈逐渐增大的趋势,而左室短轴圆周和左室长轴纵向收缩期峰值应变从心尖水平至乳头肌水平再至二尖瓣水平呈逐渐减小的趋势(P均0.05)。 ⑤Pearson相关分析表明3DT整体应变参数GLS、GCS、GRS、 GAS与LVEF均有很好的相关性,其中GLS、GCS、GAS与LVEF呈负相关(r1=-0.72, P10.05; r2=-0.70, P20.05; r3=-0.81, P30.05), GRS与LVEF呈正相关(r4=0.68,P40.05),其中GAS与LVEF的相关性较高。 ⑥应用3DT和2DT两种方法测得左心室整体纵向、圆周和径向收缩期峰值应变的研究者内和研究者间的变异系数均15%,并且研究者内和研究者间差异度之间差异无统计学意义(P均0.05)。 结论：①3DT是一种方便、快速、具有可重复性的评价左心室心肌纵向、径向和圆周应变的新方法,3DT较2DT在采集图像和脱机分析方面更省时、高效,是评价室壁运动很有前景的工具。 ②AS将是一个极有潜力的评价左心室收缩功能的指标。图9幅,表6个,参考文献23篇。
[Abstract]:Objective: to evaluate the longitudinal, circumferential and radial strain of left ventricular myocardium by three-dimensional speckle tracing (3DT) and two-dimensional speckle tracing (2DT), and to evaluate the value of 3DT in evaluating left ventricular systolic function. Methods: 46 cases of healthy examination in our hospital were examined. The images of left ventricular apical four lumen and two lumen were collected simultaneously by transthoracic ultrasound, and the 3D dynamic images of left ventricle were obtained. After the images were stored, 3DT analysis software was started for offline analysis. The left ventricular longitudinal, circumferential, radial strain and area strain, left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction were obtained, and the time taken to store and analyze the images with 3DT was recorded. Two-dimensional images of left ventricular short axis mitral valve level, papillary muscle level and apical level were collected and stored by transthoracic ultrasound, and two-dimensional images of apical four-chamber, two-chamber and left ventricular long axis were collected and stored, and 2DT analysis software was started to analyze offline images. The longitudinal, circumferential and radial strains of the left ventricle were obtained, and the left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction (LVEF) were measured by the time Simpson method using 2DT to store and analyze the images. The above two methods are analyzed and compared. Results when using 3DT, the time of storing and analyzing images was significantly shorter than that of 2DT (P0.05). Compared with 2DT, the EDV / LVEF measured by 3DT was smaller than that of 2DT. The difference was statistically significant (P0.05), but there was no significant difference between the two ESV (P0.05). The peak strain of left ventricular whole longitudinal systolic phase measured by 33DT was significantly lower than that of 2DT (P0.05), and the peak strain of whole circumferential systolic period was significantly higher than that of 2DT (P0.05). There was no significant difference in the peak global radial systolic strain between the two methods (P0.05). 4 the strain changes in three directions of left ventricular myocardium measured by 2DT from mitral valve level to apical level were the same. That is to say, the peak strain of left ventricular short axis radial systolic phase is gradually increasing from apical level to papillary muscle level to mitral valve level. But the peak strain of left ventricular short axis circumference and left ventricular long axis longitudinal systolic phase decreased gradually from apical level to papillary muscle level to mitral valve level (P0. 05). 5Pearson correlation analysis showed that 3DT global strain parameter GLS- GCS GCSs. There is a good correlation between GAS and LVEF, Among them, there was a negative correlation between GCS gas and LVEF (r1 + -0. 72, P 10. 05; r2 + -0. 70, P20. 05; r3 + -0. 81; P3. 05), GRS and LVEF). The correlation between GAS and LVEF was higher. 6 the global longitudinal of left ventricle was measured by 3DT and 2DT. The coefficient of variation of peak strain of circumference and radial contraction was 15% and there was no significant difference between researchers and researchers (P 0.05). Conclusion the new method of evaluating the longitudinal, radial and circumferential strain of left ventricular myocardium is a convenient, rapid and reproducible method. Compared with 2DT, it is more time-saving and more efficient in image acquisition and off-line analysis. 2AS will be a potential indicator of left ventricular systolic function. There are 9 figures, 6 tables and 23 references.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R540.45
本文编号：2187293
[Abstract]:Objective: to evaluate the longitudinal, circumferential and radial strain of left ventricular myocardium by three-dimensional speckle tracing (3DT) and two-dimensional speckle tracing (2DT), and to evaluate the value of 3DT in evaluating left ventricular systolic function. Methods: 46 cases of healthy examination in our hospital were examined. The images of left ventricular apical four lumen and two lumen were collected simultaneously by transthoracic ultrasound, and the 3D dynamic images of left ventricle were obtained. After the images were stored, 3DT analysis software was started for offline analysis. The left ventricular longitudinal, circumferential, radial strain and area strain, left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction were obtained, and the time taken to store and analyze the images with 3DT was recorded. Two-dimensional images of left ventricular short axis mitral valve level, papillary muscle level and apical level were collected and stored by transthoracic ultrasound, and two-dimensional images of apical four-chamber, two-chamber and left ventricular long axis were collected and stored, and 2DT analysis software was started to analyze offline images. The longitudinal, circumferential and radial strains of the left ventricle were obtained, and the left ventricular end-diastolic volume, end-systolic volume and left ventricular ejection fraction (LVEF) were measured by the time Simpson method using 2DT to store and analyze the images. The above two methods are analyzed and compared. Results when using 3DT, the time of storing and analyzing images was significantly shorter than that of 2DT (P0.05). Compared with 2DT, the EDV / LVEF measured by 3DT was smaller than that of 2DT. The difference was statistically significant (P0.05), but there was no significant difference between the two ESV (P0.05). The peak strain of left ventricular whole longitudinal systolic phase measured by 33DT was significantly lower than that of 2DT (P0.05), and the peak strain of whole circumferential systolic period was significantly higher than that of 2DT (P0.05). There was no significant difference in the peak global radial systolic strain between the two methods (P0.05). 4 the strain changes in three directions of left ventricular myocardium measured by 2DT from mitral valve level to apical level were the same. That is to say, the peak strain of left ventricular short axis radial systolic phase is gradually increasing from apical level to papillary muscle level to mitral valve level. But the peak strain of left ventricular short axis circumference and left ventricular long axis longitudinal systolic phase decreased gradually from apical level to papillary muscle level to mitral valve level (P0. 05). 5Pearson correlation analysis showed that 3DT global strain parameter GLS- GCS GCSs. There is a good correlation between GAS and LVEF, Among them, there was a negative correlation between GCS gas and LVEF (r1 + -0. 72, P 10. 05; r2 + -0. 70, P20. 05; r3 + -0. 81; P3. 05), GRS and LVEF). The correlation between GAS and LVEF was higher. 6 the global longitudinal of left ventricle was measured by 3DT and 2DT. The coefficient of variation of peak strain of circumference and radial contraction was 15% and there was no significant difference between researchers and researchers (P 0.05). Conclusion the new method of evaluating the longitudinal, radial and circumferential strain of left ventricular myocardium is a convenient, rapid and reproducible method. Compared with 2DT, it is more time-saving and more efficient in image acquisition and off-line analysis. 2AS will be a potential indicator of left ventricular systolic function. There are 9 figures, 6 tables and 23 references.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R540.45
【参考文献】
相关期刊论文 前2条
1 白姣,邓又斌,刘红云,杨好意,毕小军,常青,潘敏;心肌运动速度和应变率评价不同程度心肌缺血[J];中华超声影像学杂志;2004年10期
2 孟庆国;尹立雪;李春梅;左明良;罗安果;;超声斑点成像技术评价左心室长轴心肌节段应变与位移[J];中华超声影像学杂志;2006年10期
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