二维超声应变对心肌缺血定位的临床应用研究被引量：2

Clinical value of two-dimensional strain imaging in locating Ischemia myocardium

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摘要目的探讨二维超声应变对缺血冠脉心肌分布区域定位的准确性及临床应用价值。方法经临床确诊的冠心病及心肌梗死72例,获取其两组左室收缩期纵向峰值应变参数(LPSS)与健康正常组30例对照,对牛眼图缺血部位应变参数和范围分别与冠状动脉造影及心电图相应导联Q波、ST-T对照。结果①缺血组和梗死组左室各节段纵向收缩期峰值及整体LPSS均小于健康对照组的测值,(缺血组P<0.05,其余P均<0.001。梗死组P均<0.001、t<0.001);②两组缺血部位的LPSS与对照组比较有显著差异(P<0.05及P<0.001,t=2.597～3.216)。pearson线性相关分析牛眼图缺血节段分别与冠脉造影相对应的狭窄支、闭塞支以及相应部位心电图异常Q波及ST-T改变的大小范围均呈正相关,分别为(r=0.661,P<0.001、r=0.598,P﹤0.001。r=0.556,P<0.001、r=0.556,P﹤0.001)。结论二维超声应变能较准确地反映缺血心肌的节段运动异常,直观定位准确。对心肌缺血及梗死具有早期诊断价值。 Objective To evaluate regional dyssynergia of left ventricular of patients with cardiac ischemia or myocardial infraction by two-dimensional strain imaging （2DSI） and to identify the accuracy of using 2DSI to locate isehemia myocardi- um. Methods 36 cases with myocardial infarction （MI） and stable coronary heart disease （CHD） were respectively select- ed, while 36 cases of healthy group were selected as control group. LV longitudinal peak of systolic strain were obtained from the 3 groups. The strain parameter and the ischemia range that came from the ＂ox＇s eye＂ image with the results of cardioangiography （CAG） and electrocardiogram （ECG） were compared. Results ~ the LV global longitudinal systolic peak and LPSS of stable CHD group and MI group were both less than these of the control group （ P d0.05） ; LPSS of ischemia location in stable CHD group and MI group were both less than these of the control group （ P d0. 05, P 0. 001, t =2. 597~3. 216）. There was a positive correlation between visual ischemia range came from the ＂ox＇s eye＂ im- age and the result of CAG and ECG （ r =0. 661, P d0. 001, r =0. 598, P 〈 0. 001, r =0. 556, P d0. 001, r =0. 556, P d0. 001）. Conclusion Two-dimensional strain imaging （2DSI） can exactly reflect the wall motion abnormality of ischemia myoeardium. It is exact, direct and easy for clinical application. It plays an important role in early diagnosis of CHD and MI. The location of cardiac ischemia and MI have characteristic practice and value of clinical application.

作者王亚非于春艳张鲁春李志远王雁博王金凤马晓华

机构地区山东省泰山疗养院超声科山东省泰山疗养院查体中心山东省泰山疗养院心内科

出处《医学影像学杂志》 2013年第2期195-199,共5页 Journal of Medical Imaging

基金泰安市科技发展计划项目(编号:20103006)

关键词二维超声应变成像冠心病心肌缺血定位 Two-dimensional strain imaging Coronary heart disease Cardiac ischemia

分类号 R541.4 [医药卫生—心血管疾病] R445.1 [医药卫生—影像医学与核医学]

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