组织速度成像技术评价冠心病左室收缩功能

Systolic function of left ventricle in coronary heart disease assessed by tissue velocity imaging

目的探讨组织速度成像技术(TVI)评价冠状动脉粥样硬化性心脏病(冠心病)患者左室收缩功能的临床意义,比较定量组织速度成像(QTVI)、应变率成像(SRI)、组织追踪成像(TTI)和组织同步成像(TSI)四种方式,评价左室收缩功能的敏感性差异。方法对A组22例健康人群,B组20例左前降支和18例右冠状动脉狭窄的冠心病患者应用TVI技术采集心尖四腔切面、心尖两腔切面、心尖左室长轴切面后间隔、下壁、前壁及前间隔图像,并应用QTVI、TTI、TSI及SRI测量左室11个节段收缩期的峰值速度、位移值及收缩期最大应变率并进行定量分析。结果以A组各节段各项指标为标准,B组各节段的各项指标较A组明显减低。冠心病组总节段数为208个,QTVI、SRI、TTI、TSI对异常节段的检出比例分别为56.73%、60.58%、67.79%、50.48%。结论TVI技术能有效地定量评价冠心病的左室收缩功能,其四种方式中以TTI对评价左室收缩功能最为敏感。

Objective To investigate the clinical significance of tissue velocity imaging（TVI） and compare the sensitivity of quantitate tissue velocity imaging（QTVI）, strain rate imaging（SRI）, tissue tracking imaging（TTI） and tissue synchronization imaging （TSI） in evaluating left ventricular function in patients with coronary heart disease（CHD） .Methods 22 healthy volunteers （group A）, 20 eases with left anterior descending branch stenosis and 18 eases with right coronary artery stenosis（group B） were examined with TVI. Images of posterior septum inferior wall, anterior wall and anterior septum were got at apical four chamber view, two - chamber view and apical longitudinal view, respectively. Peak systolic velocity （Vp）, peak systolic displacement（D） and peak systolic strain rate （SR） of 11 segments were measured with QTVI,SRI,TTI and TSI.Results Vp,D and SR were significantly lower in group B than those of the corresponding segments in group A （ P 〈 0.01 or 0.05 ）. The detection rate of abnormal segments was 56.73 %, 60.58 %,67.79% and 50.48% with QTVI, SRI, TTI and TSI respectively. Conclusion TVI can quantitatively assess left ventrielar systolic function in CHD, among which TTI is the most sensitive.