超声应变率成像估测圆锥动脉干畸形术后右心室局部功能的研究

Ultrasonic study on the evaluation of regional right ventricular function by strain rate imaging after surgical repair of conotruncal defects

目的 应用超声应变率成像评估圆锥动脉干畸形（CTD）患者术后右心室局部功能的变化.方法 27例CTD术后儿童为研究对象,应用磁共振检查计算右心室射血分数.采集该27例患儿以及性别、年龄与之配对的正常儿童的右室前壁的超声应变率图像.测量各节段的收缩期峰值应变率（SRs）、应变（S）、舒张早期峰值应变率（Sre）、舒张晚期峰值应变率（Sra）.并把各指标与磁共振所测右心室射血分数行相关分析.结果 CTD术后患儿与正常儿童相比.各心肌节段SRs、S、Sre、Sra值均显著下降（P＜0.01）,病例组各指标值在基底段、中间段和心尖段各节段之间差异无统计学意义（P＞0.05）;右室前壁基底段SRs与磁共振测得射血分数相关性较好（r=0.89,P＜0.01）.结论 CTD术后患儿依然存在右心室局部心功能的下降.超声应变率成像可以比较准确地反映右心室局部功能的变化.

Objective To evaluate regional right ventricular function by ultrasonic strain rate imaging in postoperative children with conotruncal defects（CTD）. Methods All 27 postoperative CTD children had magnetic resonance imaging evaluation of right ventricular end-diastolic volume and end-systolic volume to calculate right ventricular ejection fraction （RVEF）. The ultrasonic parameters of peak systolic strain rate （SRs）, peak early diastolic strain rate （SRe）, peak late diastolic strain rate（SRa） and strain （S） were obtained at the basal,middle and apical segment in curve of right ventricular anterior wall in 27 postoperative CTD children and 27 normal children. The correlation between SRs,S and RVEF were evaluated. Results Compared with healthy children,SRs,S,SRe,SRa were significantly reduced in postoperative CTD children （P ＜ 0.01 ）, there were different distribution rules between postoperative CTD children and normal children,and all indexes had no statistical descrepancy among the basal, middle and apical segment （ P ＞0.05）. SRs in basal segment of the right ventricular anterior wall correlated well with RVEF （ r = 0.89,P ＜ 0. 01 ）. Conclusions Regional right ventricular function still was reduced in postoperative CTD children, and could be accurately evaluated by ultrasonic strain rate imaging.