实时三维超声心动图评价儿童左室心肌收缩位移的应用研究

Real-Time Three-Dimensional Echocardiographic Assessment of Left Ventricular Regional Systolic Excursion in Children

目的:探讨实时三维超声心动图在评价儿童左室各节段心肌室壁运动位移中的应用价值。方法:应用PhilipsIE33型超声诊断仪,X7-2实时三维矩阵探头,检测55例正常儿童及10例扩张型心肌病(DCM)儿童。对获得的三维数据采用Qlab软件进行脱机分析,获得左室各节段心肌的最大收缩位移值,以及室壁收缩位移占舒张末期室壁到左室重心距离的百分比,即圆心位移值。结果:正常对照组中,各节段心肌位移值及圆心位移值接近正态分布;各节段心肌位移值及圆心位移值性别间比较差异无统计学意义(P>0.05);部分节段心肌位移值随年龄增长而升高,各节段圆心位移值随年龄增长而降低;心尖段位移平均值小于基底段和中间段;基底段圆心位移值平均值大于中间段和心尖段。室间隔各节段圆心位移平均值与左室其他各节段比较差异无统计学意义(P<0.05),但基底段室间隔位移平均值小于基底段其他各节段位移平均值。DCM组左室各节段圆心位移值明显小于正常对照组。结论:圆心位移值能够较敏感地检测出收缩功能减低的心肌节段,可利用其作为评价不同年龄儿童左室收缩时室壁运动的指标。

Objective：To investigate the clinical value of real-time three-dimensional echocardiography（RT3DE） in assessment of left ventricular systolic excursion in children.Methods：Ten children with dilated cardiomyopathy（DCM） and 55 normal children were detected by full-volume RT3DE using Philips IE33 with the X7-2 matrix array 3D transducer.Post-processing software Qlab（version 5.1.2） was used for advanced analysis.The average excursion and average ball excursion of every segments of left ventricular（LV） can be automatically measured by RT3DE.Results：In control group,there were no significant differences in excursion and ball excursion between genders.The excursion of apical LV segment was smaller than that of middle and basal segments.The ball excursion of basal segments was larger than that of middle and apical segments.There was no statistical difference in excursion and ball excursion between ventricular septum and other segments.The ball excursion was significantly smaller in DCM group than that of the normal group.Conclusion：Ball excursion can be used to assess the systolic function of all the segments of left ventricle.RT3DE is a feasible and accurate method for analysis left ventricular systolic function in children.