三维超声心动图、应变率显像在室间隔运动分析中与二维的比较

Real time 3D-echocardiography,strain rate imaging in ventricular septum motion analysis

目的:探讨实时三维超声心动图(RT3DE)、应变率显像(SRI)技术在室壁运动分析中的应用价值。方法:应用RT3DE、SRI对62例有心前区不适、胸闷,二维超声心动图室壁运动正常(T1组,30例)、室间隔运动异常(T2组,32例)的患者及30例正常人(N组)对室间隔运动进行评价。结果:①RT3DE:T2组Tmsv 6-SD、Tmsv 12-SD、Tmsv 16-SD、Tmsv 6-Dif and Tmsv 6-SD%、Tmsv 16-SD%、Tmsv 6-Dif%明显高于N组(P<0.05),两组间Tmsv 3-6 Dif有差别。T2组的室间隔基底段和中间段、前间隔中间段收缩末期EDV%明显高于N组(P<0.01)。T1组与N组间无显著性差异(P>0.05)。②SRI:T2组室间隔基底段、中间段及心尖段收缩期、舒张早期应变率峰值低于N组(P<0.05),T1组室间隔基底段舒张早期应变率峰值低于N组(P<0.05)。结论:RT3DE和SRI技术在室壁运动分析中具有较好的准确性、可行性,为快速、客观、定量评价室壁运动异常提供了新方法。

Objective： To explore the value of real-time three dimensional echocardiography （RT3DE）, strain rate imaging （SRI） in ventricular wall motion analysis. Method： Sixty-two patients with heart attack symptoms and 30 healthy volunteers were enrolled in this study. The patients were divided into two groups, according to 2DE; T1 group were composed of individuals with normal wall motion in 2DE, and T2 group were composed of individuals with abnormal ventricular septum motion in 2DE. RT3DE, SRI were performed. Results： There were differences among Tmsv 6-SD, Tmsv 12-SD, Tmsv 16-SD, Tmsv 6-Dif and Tmsv 6-SD%, Tmsv 16-SD%, Tmsv 6-Dif% of T2 group and normal control group（P〈0.05）. End systolic EDV% of 17 segment in T2 group showed significant differences in basal inferoseptal, mid inferoseptal, mid anteroseptal compared with that of normal control. There is no difference between T1 group and T2 group. The analysis on strain rate showed that the peak value of basal, mid, apical ventricular septum of T2 group during systolic phase and early diastolic phase reduced obviously compared with that of control group. There was a decrease of peak value of basal ventricular septum in diastolic phase of T1 group compared with normal control. Conclusion： RT3DE and SRI have obvious superiority in wall motion assessment, which provide new methods of assessing abnormal wall motion more quickly, objectively and quantitatively.