实时三平面定量组织速度成像技术评价冠心病患者心室壁运动

Evaluation of Ventricular Wall Motion in Coronary Heart Disease by Real-time 3-plane Quantitative Tissue Velocity Imaging

目的探讨实时三平面定量组织速度成像技术在冠心病诊断中的临床应用价值。方法同步实时采集行冠状动脉造影检查的139例患者(分为4组)心尖四腔观、心尖两腔观和心尖左室长轴观的组织速度动态图像,测量左右心室壁基底段的收缩及舒张速度,并做对比研究。结果左室部分室壁收缩及舒张速度在组间比较有统计学意义(P<0.05或P<0.01),并与冠状动脉狭窄程度存在相关性(P<0.05或P<0.01);左室下壁舒张早期峰值速度(e)以截断值为-5.19cm/s对冠状动脉狭窄≥50%的诊断价值最高(P<0.01)。结论实时三平面定量组织速度成像技术可较准确地分析心肌缺血时收缩及舒张运动的速度变化,对评价缺血心肌的敏感性优于常规超声心动图。

Objective To evaluate the clinical value of real - time 3 - plane quantitative tissue velocity imaging in diagnosis of coro- nary heart disease （CHD）. Methods Total 139 cases with CHD were proved by coronary angiography and synchronous real - time dynamic image acquisition of tissue velocity imaging,including apical 4 - chamber view, apical 2 - chamber view, and long axis of left ventricle（LV） view were studied. Systolic and diastolic velocities of the left and right ventricular walls＇ basal segments were observed. Results Some velocity parameters indicated significant difference in several I.V walls＇ basal segments （P〈0.05 or P〈0.01）. Furthermore,some parameters showed good correlation with the degree of coronary artery stenosis（P〈0.05 or P〈0.01）. The cut value of early diastolic velocity in LV inferior wall was -5.19 cm/s,and which had maximum diagnostic value in coronary artery stenosis 950% （P〈0.01）. Conclusion The real - time 3 - plane quantitative tissue velocity imaging could used to evaluate systolic and diastolic velocities of ventricular walls,and it was higher sensitivity than conventional echocardiography for the diagnosis of myocardial ischemia.