实时三维斑点追踪成像技术评价正常成人左心室收缩功能的效果

Evaluation on left ventricular systolic strain in healthy adults by using real-time three-dimensional speckle tracking imaging

目的应用实时三维斑点追踪技术(3D-STI)定量评价健康成年人左心室纵向、环向、径向及面积应变特征,探讨3D-STI评价左心室收缩功能的可行性及应用价值。方法选择健康志愿者30例,采集心尖四腔切面的4D全容积图像并储存,随后进行在线分析,计算左心室节段性收缩期峰值纵向应变(LS)、左心室节段性收缩期峰值环向应变(CS)、左心室节段性收缩期峰值径向应变(RS)、左心室节段性收缩期峰值面积应变(AS),并分析左心室室壁不同水平节段的收缩期三维应变的变化情况。结果健康男性组与女性组间的常规超声心动图测得的左心室舒张末期容积(LVEDV),左心室收缩末期容积(LVESV),室间隔舒张末期厚度(IVST),左室后壁舒张末期厚度(LVPWT),左心室射血分数(EF),左心室短轴收缩率(FS)、二尖瓣舒张早期最大峰值流速E峰/舒张末期最大峰值流速(E/A)值差异无统计学意义(P>0.05)。健康成年人左心室室壁三水平节段的LS、CS及AS比较,在心尖水平最高,其次为乳头肌水平,二尖瓣水平最低(P<0.05),而RS则为在二尖瓣水平处最高,其次为乳头肌水平,心尖水平最低(P<0.05)。结论 3D-STI是一种新的心脏功能成像方法,可全面、立体、客观地评价正常人左心室节段性的LS、CS、RS以及AS,为临床定量评估左心室收缩功能提新思路。

Objective To quantitatively evaluate the features of left ventricular longitudinal strains,circumferential strains,radial strains and area strains in healthy adults by using three-dimensional ultrasound speckle tracking imaging（3D-STI）,and to explore the feasibility and value of 3D-STI applied to evaluating left ventricular systolic function.Methods The full volume 4D images of four-chamber were obtained from 30 healthy volunteers and then were analyzed on line.Left ventricular segmental peak systolic longitudinal strain（LS）, left ventricular segmental peak systolic circumferential strain（CS）,left ventricular segmental peak systolic radial strain（ RS） and left ventricular segmental peak systolic area strain（AS） were calculated,and the changes in systolic three-dimensional（3D） strains of different left ventricular segmental levels were analyzed.Results There were no significant differences in the left ventricular end-diastolic volume （LVEDV）,left ventricular end-sostolic volume（LVESV）,interventricular septum thickness（IVST）,left ventricular posterior wall thickness （LVPWT）,left ventricular ejection fraction（EF）,left ventricular fractional shortening（FS） or mitral valve peak flow velocity E/A ratio （E /A） determined by conventional echocardiography between healthy males and females（P 〉0.05）.LS,CS and AS of left ventricular segmental levels were the largest at apex level and the smallest at mitral level,while RS of left ventricular segmental levels was the largest at mitral level and the smallest at apex level among healthy adults （P 〈0.05）.Conclusion 3D-STI is a new cardiac imaging methodology, which contributes to a comprehensive,spatial and impersonal evaluation on LS,CS,RS and AS of left ventricular segments among healthy individuals.It might provide a new idea for assessing the left ventricular systolic function quantitatively.