摘要
目的观察超声三维斑点追踪技术(three-dimensional speckle tracking echocardiography,3DSTE)和面积应变(area strain,AS)在冠心病所致室壁运动异常检测中的价值。方法将疑似冠心病的46例患者在冠脉造影检查前分别行常规和三维超声心动图检查,根据冠脉造影结果分为心肌缺血组(至少一支冠状动脉主要分支狭窄≥70%)和对照组(冠脉狭窄程度<70%)。运用常规二维超声心动图技术计算节段性室壁运动积分(wall-motion score,WMS)及室壁运动积分指数(WMS index,WMSI),三维斑点追踪技术计算应变参数。运用受试者工作特性(receiver-operating characteristic,ROC)曲线及线性回归分析超声指标与冠脉造影结果间的相关性。结果与对照组相比,冠状动脉严重狭窄的患者(狭窄程度≥70%)左室射血分数下降,WMSI升高,整体应变下降。ROC曲线显示节段性WMS检测局限性心肌缺血及梗死的敏感度均较低,3DSTE节段性应变参数可准确评估局限性室壁运动异常。在所有应变参数中节段性面积应变>-25%用于检测缺血及梗死区域的敏感度和特异度最高。结论 3DSTE是快速准确评估节段性心肌运动的重要手段,AS是准确性及可重复性高的重要指标。
Objective To investigate the value of three-dimensional speckle tracking echocardiography （3DSTE） and the novel areas train （AS） in detecting wall motion abnormalities caused by coronary artery diseases. Methods Conventional and 3D echocardiography was done on forty-six patients suspected with coronary heart diseases, immediately before they received cardiac catheterization. Segmental wall-motion score （WMS） and WMS index （WMSI） were assessed on conventional two-dimensional （2D） images, and strain-derived parameters were analyzed by speckle tracking technique based on 3D images. The accuracy of echocardiographic parameters to assess the regional myocardial ischemia was tested against coronary angiography results using ROC curve analysis and linear regression. Results Compared with controls, patients with severe coronary stenosis （≥70% coronary stenosis） had lower left ventricular ejection fraction, higher WMSI and lower global strains. ROC curve analysis demonstrated that segmental WMS had relatively poor sensitivity for regional myocardial ischemia and infarction. The segmental strains measured using 3DSTE provided accurate assessment of the regional wall motion abnormalities. The segmental area strain 〉- 25% yielded the best sensitivity and specificity for detecting the ischemic and infracted segments among all four strain parameters. Conclusion 3DSTE provides a swift and accurate assessment of regional myocardial motion. The novel area strain derived by 3DSTE is an accurate and reproducible index for regional wall motion abnormality.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2013年第4期651-656,共6页
Journal of Sichuan University(Medical Sciences)
基金
四川省科技支撑计划(No.2012SZ0028)
成都市科技计划项目(No.10GGYB076SF-023)资助
关键词
三维斑点追踪
面积应变
室壁运动异常
超声心动图
Three-dimensional speckle tracking Area strain Wall motion abnormalities Echocardiography
