定量组织速度成像技术评价冠心病患者冠状动脉病变的价值

Value of quantitative tissue velocity imaging in evaluating coronary lesions of the patients with coronary artery disease

目的探讨定量组织速度成像(QTVI)技术评价冠心病患者冠状动脉病变的价值。方法选择经冠脉造影诊断为冠心病的患者41例,根据冠脉造影结果将所有患者左心室各节段分为无病变、轻度病变、中度病变和严重病变节段4组,应用组织多普勒定量组织速度成像技术,测定所有患者在静息和潘生丁负荷状态下左心室各节段室壁运动变化,并与冠脉造影所得的结果相比较。结果冠脉病变节段的平均收缩期运动速度(Vs)较正常节段减低,舒张早期充盈速率(Ve)和舒张晚期充盈速率(Vs)比值<1,节段心肌等容舒张时间(RIVRT)延长。结合潘生丁负荷试验可使这些变化更明显,以冠脉造影结果为标准,其判断血管病变敏感性为93.7%,特异性为86.4%。结论定量组织速度成像技术检测左心室各节段心肌功能变化,可用来评价冠心病患者冠状动脉病变,结合潘生丁负荷试验,可提高判断的敏感性和特异性。

Objective To assess the clinical value of quantitative tissue velocity imaging （QTVI） in evaluating coronary lesions of the patients with coronary artery disease. Methods Forty-one patients were found having coronary artery stenosis by coronary angiography. All of segments of left ventricle were divided into four groups according the results of coronary angiography： normal segments, mild abnormal segments, intermediate abnormal segments and severe abnormal segments. Left ventricular wall moventent of all segments at both rest status and persantin stress were measured by quantitative tissue velocity imaging. Compared the results between coronary angiography and QTVI. Results Vs of abnormal segments reduce compared with normal segments. Ve/Vs〈1.RIVAT prolonged significantly. These parameters become obvious at persantin stress. The sensibility of persantin stress QTVI predict coronary lesions was 93.7%. The accuracy was 86.4%. Conclusion QTVI could evaluate coronary lesions of the patients with coronary artery disease by measuring the left ventricular regional wall movement. Persantin QTVI could improve the sensibility and accuracy furtherly.