彩色M型多谱勒组织成像技术在冠心病中的应用价值

Value of color M-mode Doppler tissue imaging in the diagnosis of coronary heart disease

目的:探讨彩色M型多谱勒组织成像(DTI)检测冠心病局部室壁运动异常及评价经皮冠状动脉成形术(PTCA)后室壁运动的变化的临床应用价值。方法:应用彩色M型多谱勒组织成像技术对51例冠心病患者(观察组)和35例正常对照者(对照组)的左室短轴方向心肌运动速度跨壁梯度(MVGm)及心内外膜运动峰值速度(Vend、Vepi)进行检测,并比较PTCA治疗前、后MVGm、Vend、Vepi的变化。结果:观察组与对照组比较,室壁运动异常节段MVGm、Vend、Vepi明显减小(P<0.01);冠心病患者PTCA术前后比较,室壁运动恢复节段MVGm、Vend、Vepi均明量增高(P<0.01),室壁运动未恢复节段MVGm、Vend、Vepi增高但无统计学意义(P>0.05)。结论:彩色M型DTI可定量检测心肌运动变化情况,评价PTCA前、后室壁运动改善情况,为冠心病的检测及PTCA治疗部效判断提供新的定量指标。

Objective. To evaluate the value of M-mode Doppler tissue imaging （DTI） for detection of regional ventricular wall motion abnormalities in coronary heart disease （CHD） and changes in wall motion in patients underwent percutaneous transluminal coronary angioplasty （PTCA）. Methods： The myocardial velocity gradient （MVGm） and endocardial, epicardial peak velocities （Vend, Vepi） of left ventricular in short axis view were assessed in 51 CHD patients （observation group） and 35 healthy individuals （control group） using color M-mode DTI. The changes in MVGm, Vend, Vepi between prior and post PTCA treatment were compared in patients underwent PTCA. Results. Compared with the control, the segments with abnormal wall motion in observation group decreased significantly （P〈0.01）. MVGm, Vend, Vepi of recovered wall segments increased significantly （P〈0.01） in CHD patients after PTCA treatment, while increase in MVGm, Vend, Vepi of unrecovered wall segments were not significant （P〉 0.05）. Conclusions：Color M-mode DTI can be used to detect myocardial motion quantitatively and to evaluate the improvement of ventricular wall motion after PTCA treatment, providing a new quantitative index for detection of CHD and estimation of PTCA efficiency.